Doctoral candidate in the School of Population and Public Health at the University of British Columbia and a researcher at the Centre for Clinical Epidemiology and Evaluation at the Vancouver Coastal Research Institute.
Associate Professor in the Department of Emergency Medicine at the University of British Columbia and a scientist in the Centre for Clinical Epidemiology and Evaluation.
Can Fam Physician. 2020 Feb;66(2):e69-e77.
To determine whether higher frequency of GP visits among insulin-dependent patients with type 2 diabetes is associated with reduced hospitalizations.
Nationally representative study using data from the 2013-2014 cycle of the Canadian Community Health Survey.
Canada.
A study sample comprising 2203 insulin-dependent Canadians with type 2 diabetes.
The relationship between GP visits (no visits, 1-5 visits, ≥ 6 visits) in the past year and the number of nights spent in-hospital. Zero-inflated negative binomial Poisson regression models were used to account for overdispersion and excess zeros.
Higher numbers of GP visits were associated with spending fewer nights in-hospital. Patients with 1 to 5 GP visits had a significantly lower number of nights spent in-hospital (rate ratio of 0.38, 95% CI 0.25 to 0.56), as did those with 6 or more GP visits (rate ratio of 0.57, 95% CI 0.38 to 0.84) despite having reduced odds of not being hospitalized (odds ratio of 0.62, 95% CI 0.39 to 0.95), compared with those who did not see a GP in the past year, after adjusting for confounders.
We found that insulin-dependent patients with diabetes who saw GPs more frequently were hospitalized less commonly compared with those who did not see a GP in the past year. Further research is needed to examine relationships with other types of follow-up, ideally using a longitudinal design.
确定 2 型糖尿病依赖胰岛素患者就诊频率的增加是否与住院次数的减少有关。
利用 2013-2014 年加拿大社区健康调查数据进行的全国代表性研究。
加拿大。
研究样本包括 2203 名加拿大 2 型糖尿病依赖胰岛素患者。
过去一年中全科医生就诊次数（无就诊、1-5 次就诊、≥6 次就诊）与住院夜数之间的关系。使用零膨胀负二项泊松回归模型来解释过分散和过多的零值。
就诊次数越多，住院夜数越少。与过去一年未就诊的患者相比，就诊 1-5 次的患者住院夜数显著减少（就诊次数比为 0.38，95%CI 0.25 至 0.56），就诊 6 次或以上的患者住院夜数也减少（就诊次数比为 0.57，95%CI 0.38 至 0.84），尽管他们住院的可能性降低（就诊次数比为 0.62，95%CI 0.39 至 0.95），与过去一年未就诊的患者相比，在调整混杂因素后。
我们发现，与过去一年未就诊的患者相比，就诊更频繁的糖尿病依赖胰岛素患者住院次数较少。需要进一步研究与其他类型随访的关系，最好采用纵向设计。
