Anderson R M, Hess G E, Davis W K, Hiss R G
University of Michigan Medical School, Towsley Center for Continuing Medical Education, Ann Arbor 48109-0201.
Diabetes Care. 1988 Jul-Aug;11(7):519-26. doi: 10.2337/diacare.11.7.519.
This is a study of diabetes care and care outcomes for patients under the active care of private physicians. Randomly selected communities, physicians, and patients in Michigan were the subjects of this study. Data on the care practices of physicians and patients and care outcomes were collected from 1980 to 1981 and again in 1985 from eight communities, 61 physicians, and 261 patients. We found that the use of multiple injections of insulin and self-monitoring of blood glucose increased significantly, whereas hospitalizations for diabetes control decreased. The mean glycosylated hemoglobin values for this cohort of patients remained unchanged. The study results suggest that, for patients under the active care of community physicians, modern methods of diabetes care are being implemented, but the results of improved care do not show an impact on blood glucose control as measured by glycosylated hemoglobin values. The study was not designed to establish causation for the decrease in hospitalizations for these patients, but the data suggest that decreases may be more a function of changes in health-care policies rather than changes in patient health.
这是一项针对在私人医生积极护理下的糖尿病患者的糖尿病护理及护理结果的研究。密歇根州随机选取的社区、医生和患者是本研究的对象。1980年至1981年以及1985年再次从八个社区、61名医生和261名患者那里收集了有关医生和患者护理实践及护理结果的数据。我们发现，胰岛素多次注射的使用和血糖自我监测显著增加，而因糖尿病控制住院的情况减少。该队列患者的糖化血红蛋白平均值保持不变。研究结果表明，对于在社区医生积极护理下的患者，正在实施现代糖尿病护理方法，但改善护理的结果并未显示出对糖化血红蛋白值所衡量的血糖控制产生影响。该研究并非旨在确定这些患者住院率下降的原因，但数据表明，住院率下降可能更多是医疗保健政策变化的作用，而非患者健康状况的变化。
