巴西东南部初级卫生服务中糖尿病患者的护理质量
Quality of Care of Patients with Diabetes in Primary Health Services in Southeast Brazil.
作者信息
Simão Christiane Chaves Augusto Leite, Costa Mônica Barros, Colugnati Fernando Antônio Basile, de Paula Elaine Amaral, Vanelli Chislene Pereira, de Paula Rogério Baumgratz
机构信息
Postgraduate Program in Brazilian Health, School of Medicine, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento, s/n, Bairro Dom Bosco, 36.038-330 Juiz de Fora, MG, Brazil.
出版信息
J Environ Public Health. 2017;2017:1709807. doi: 10.1155/2017/1709807. Epub 2017 Oct 10.
BACKGROUND
Diabetes management involves multiple aspects that go beyond drug therapy as a way of providing high quality care. The objective of this study was to describe quality of care indicators for individuals with diabetes in southeast Brazil and to explore associations among these indicators.
METHODS
In this cross-sectional, observational study, health care providers filled out a questionnaire addressing health care structure and processes at 14 primary health care units (PHCUs). Clinical and laboratory data of diabetic patients attending the PHCUs and from patients referred to a secondary health care (SHC) center were collected.
RESULTS
There was a shortage of professionals in 53.8% of the PHCUs besides a high proportion of problems regarding referrals to SHC. At the PHCU, glycated hemoglobin results were available only in half of the medical records. A low rate of adequate glycemic control was also observed. An association between structure and process indicators and the outcomes analyzed was not found.
CONCLUSION
Major deficiencies were found in the structure and processes of the PHCUs, in addition to unsatisfactory diabetes care outcomes. However, no association between structure, process, and outcomes was found.
背景
糖尿病管理涉及多个方面，不仅仅是药物治疗，这是提供高质量护理的一种方式。本研究的目的是描述巴西东南部糖尿病患者的护理质量指标，并探讨这些指标之间的关联。
方法
在这项横断面观察性研究中，医疗服务提供者填写了一份关于14个初级卫生保健单位（PHCU）的医疗保健结构和流程的问卷。收集了在PHCU就诊的糖尿病患者以及转诊至二级卫生保健（SHC）中心的患者的临床和实验室数据。
结果
53.8%的PHCU存在专业人员短缺的情况，此外，转诊至SHC的问题比例也很高。在PHCU，糖化血红蛋白结果仅在一半的病历中可用。还观察到血糖控制良好的比例较低。未发现结构和流程指标与所分析的结果之间存在关联。
结论
除了糖尿病护理结果不尽人意外，PHCU的结构和流程还存在重大缺陷。然而，未发现结构、流程和结果之间存在关联。
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