Ugolini Cristina, Lippi Bruni Matteo, Leucci Anna Caterina, Fiorentini Gianluca, Berti Elena, Nobilio Lucia, Moro Maria Luisa
Department of Economics and CRIFSP-School of Advanced Studies in Health Policy, University of Bologna, Italy.
Department of Economics and CRIFSP-School of Advanced Studies in Health Policy, University of Bologna, Italy.
Health Policy. 2019 Oct;123(10):955-962. doi: 10.1016/j.healthpol.2019.08.014. Epub 2019 Aug 24.
Although the study of the association between interventions in primary care and health outcomes continues to produce mixed findings, programs designed to promote the greater compliance of General Practitioners and their diabetic patients with guidelines have been increasingly introduced worldwide, in an attempt to achieve better quality diabetes care through the enhanced standardisation of patient supervision. In this study, we use clinical data from the Diabetes Register of one large Local Health Authority (LHAs) in Italy's Emilia-Romagna Region for the period 2012-2015. Firstly, we investigate whether GPs' participation in the local Diabetes Management Program (DMP) leads to improved patient compliance with regional guidelines. Secondly, we test whether the monitoring activities prescribed for diabetics by the Regional diabetes guidelines have a positive impact on patients' health outcomes and increase appropriateness in health care utilization. Our results show that such a Program, which aims to increase GPs' involvement and cooperation in following the Regional guidelines, achieves its goal of improved patient compliance with the prescribed actions. In turn, through the implementation of the DMP and the greater involvement of physicians, Regional policies have succeeded in promoting better health outcomes and improved appropriateness of health care utilization.
尽管对初级保健干预措施与健康结果之间关联的研究仍不断产生喜忧参半的结果，但为促使全科医生及其糖尿病患者更好地遵循指南而设计的项目已在全球范围内越来越多地推行，旨在通过加强患者监管的标准化来实现更高质量的糖尿病护理。在本研究中，我们使用了意大利艾米利亚 - 罗马涅地区一个大型地方卫生当局（LHA）2012 - 2015年期间糖尿病登记处的临床数据。首先，我们调查全科医生参与当地糖尿病管理项目（DMP）是否会提高患者对地区指南的依从性。其次，我们测试地区糖尿病指南规定的糖尿病患者监测活动是否对患者的健康结果产生积极影响，并提高医疗保健利用的合理性。我们的结果表明，这样一个旨在增加全科医生在遵循地区指南方面的参与度与合作的项目，实现了提高患者对规定行动依从性的目标。反过来，通过实施DMP以及医生更多的参与，地区政策成功地促进了更好的健康结果，并提高了医疗保健利用的合理性。
