Institute of General Practice, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. Email:
Am J Manag Care. 2018 Jul;24(7):322-327.
To compare the development of diabetes complications, measured in terms of clinical end points, of patients enrolled in general practitioner (GP)-centered healthcare (Hausarztzentrierte Versorgung [HZV]) and patients in usual GP care (non-HZV) over 4 years.
Retrospective closed cohort study based on German claims data.
The main end points in our evaluation were dialysis, blindness, amputation, stroke, myocardial infarction, cardiovascular disease, hypoglycemia, and mortality. We used Cox proportional hazards regression models for multivariable analysis.
We included 217,964 patients in our study: 119,355 were enrolled in HZV and 98,609 were in non-HZV. Compared with non-HZV, the HZV group had a 15.6% lower risk of requiring dialysis during the 4 years of observation. Risks were also lower in the HZV group for all other end points except mortality.
The results of the present study indicate that GP-centered healthcare is associated with a delay in the occurrence of serious diabetes complications and reduces the risk of diabetes complications. This may be because GP-centered care is associated with improved coordination of care.
比较接受全科医生为中心的医疗保健（Hausarztzentrierte Versorgung [HZV]）和常规全科医生护理（非 HZV）的患者在 4 年内发生的糖尿病并发症（根据临床终点衡量）的发展情况。
基于德国索赔数据的回顾性封闭队列研究。
我们评估的主要终点是透析、失明、截肢、中风、心肌梗死、心血管疾病、低血糖和死亡率。我们使用 Cox 比例风险回归模型进行多变量分析。
我们纳入了 217964 名患者：119355 名患者参加了 HZV，98609 名患者参加了非 HZV。与非 HZV 相比，HZV 组在观察的 4 年内需要透析的风险降低了 15.6%。除死亡率外，HZV 组在所有其他终点的风险也较低。
本研究结果表明，全科医生为中心的医疗保健与严重糖尿病并发症发生的延迟有关，并降低了糖尿病并发症的风险。这可能是因为全科医生为中心的医疗保健与护理协调的改善有关。
