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移民与非移民糖尿病患者的糖尿病护理过程指标依从性比较:一项回顾性队列研究。

Adherence to diabetes care process indicators in migrants as compared to non-migrants with diabetes: a retrospective cohort study.

机构信息

Agenzia Regionale Sanità, Regione Toscana, Via Pietro Dazzi, 1, 50141, Florence, Italy.

Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy.

出版信息

Int J Public Health. 2019 May;64(4):595-601. doi: 10.1007/s00038-019-01220-5. Epub 2019 Mar 13.

Abstract

OBJECTIVES

Prevalence rate of diabetes is high among migrants. Whether migrants are correctly addressed to a standard quality of care for diabetes and are properly followed up are the questions addressed by this retrospective cohort study.

METHODS

Compliance to one or repeated Guideline Composite Indicator (GCI), a standard process indicator of care quality, was tested in migrants compared to non-migrant Italian residents with diabetes, living in Tuscany Region, Italy, in years 2011-2015. For those with no GCI, the analysis was repeated for the chance of being tested by at least one or more HbA1c measurements.

RESULTS

GCI compliance, in a single or repeated manner over time, was significantly less likely by about 15-20% among migrants (n = 3992) compared to non-migrants (n = 130,874), even after fully matching both cohorts. For those with no GCI, being tested by HbA1c was still significantly less likely among migrants.

CONCLUSIONS

Being addressed to a standard quality of care is impaired among migrant patients with diabetes living in Tuscany compared to non-migrants. Migrants, moreover, have a significantly lower probability of adhering to guidelines or to be tested by HbA1c measurement over time.

摘要

目的

移民中糖尿病的患病率较高。本回顾性队列研究旨在探讨移民是否能获得糖尿病标准的高质量护理,以及是否能得到妥善的随访。

方法

在意大利托斯卡纳地区,2011 年至 2015 年,将符合或多次符合指南综合指标(GCI)的情况与患有糖尿病的非移民意大利居民进行比较,以检验移民患者的护理质量标准过程指标的依从性。对于没有 GCI 的患者,分析了至少进行一次或多次 HbA1c 检测的可能性。

结果

与非移民(n=130874)相比,在单次或多次重复的情况下,移民(n=3992)的 GCI 依从性显著降低了约 15-20%,即使在完全匹配两个队列后也是如此。对于那些没有 GCI 的患者,HbA1c 检测的可能性仍然显著降低。

结论

与非移民相比,居住在托斯卡纳的移民糖尿病患者获得标准护理的情况较差。此外,移民患者随着时间的推移,遵循指南或接受 HbA1c 检测的可能性显著降低。

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