Isaacs R D, Scott D J
Department of Medicine, University of Auckland School of Medicine, Middlemore Hospital.
N Z Med J. 1987 Oct 14;100(833):629-31.
Diabetes mellitus is a significant health problem in south Auckland. A retrospective case note review of all diabetic admissions to Middlemore Hospital in 1983 was performed to establish a database to identify current problem areas and permit ongoing analysis. Three hundred and seventeen admissions from 225 patients using 6086 hospital days were reviewed: 204 diabetes-related admissions occupied 4040 days. One hundred and nine patients were male. One hundred and fifty-seven patients were European, 45 were Maori and 21 were Polynesian. European patients were older (mean age 64 years) and lighter (mean weight 69kg) than the non-European patients (mean age 56 years, mean weight 83kg). One hundred and eighty patients had noninsulin dependent diabetes mellitus: European patients were discharged on insulin treatment in 38% of admissions compared with 17% for nonEuropean patients. The patterns of admission were similar for all racial groups except for admissions for chronic renal failure where 21 of 22 admissions were by nonEuropean patients. A comparative cost analysis was performed: admissions for peripheral vascular disease contributed 34% to the calculated total cost of diabetes-related admissions despite only accounting for 17% of admissions. Further research, especially in the nutritional field, is necessary before realistic cost-benefit interventions can be devised and implemented.
糖尿病是奥克兰南部一个严重的健康问题。对1983年所有入住Middlemore医院的糖尿病患者病历进行回顾性分析,以建立一个数据库,确定当前存在问题的领域,并进行持续分析。共审查了225名患者的317次入院记录,占用医院天数6086天:其中204次与糖尿病相关的入院记录占用4040天。109名患者为男性。157名患者为欧洲人,45名是毛利人,21名是波利尼西亚人。欧洲患者比非欧洲患者年龄更大(平均年龄64岁)、体重更轻(平均体重69千克)(非欧洲患者平均年龄56岁,平均体重83千克)。180名患者患有非胰岛素依赖型糖尿病:欧洲患者在38%的入院记录中出院时接受胰岛素治疗,而非欧洲患者这一比例为17%。除慢性肾衰竭入院情况外,所有种族群体的入院模式相似,22例慢性肾衰竭入院记录中有21例是非欧洲患者。进行了一项成本比较分析:外周血管疾病入院治疗占糖尿病相关入院治疗计算总成本的34%,尽管其仅占入院记录的17%。在制定并实施切实可行的成本效益干预措施之前,有必要开展进一步研究,尤其是在营养领域。