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社区诊所中糖尿病专科护士主导的远程护理的疗效:一项回顾性队列研究。

Efficacy of diabetes specialist nurse-led remote care in community clinics: a retrospective cohort study.

作者信息

Kivity Sara, Arbeli Sima, Cohen Josef, Sabah Oded, Saban Mor

机构信息

Tel Aviv University, Tel Aviv, Ramat Aviv, Israel.

Maccabi Health Care Services, Tel Aviv, Israel.

出版信息

BMC Nurs. 2025 May 12;24(1):514. doi: 10.1186/s12912-025-03074-0.

Abstract

BACKGROUND

This study evaluates the impact of a diabetes specialist nurse intervention on clinical outcomes and healthcare utilization among patients with diabetes.

METHODS

A cohort of 452 patients was observed from 2019 to 2022. Clinical metrics such as HbA1C levels and BMI, as well as healthcare utilization patterns, were analyzed before and after the intervention. The intervention was conducted mostly during the COVID-19 pandemic.

RESULTS

There was a modest reduction in HbA1C levels, though this change was not statistically significant. Remote visits to primary care physicians increased significantly, reflecting a shift towards telemedicine. The intervention did not significantly alter BMI values, which remained stable despite the aging cohort and progression of the disease. However, In-person visits showed a slight decline, while Diabetes specialists and endocrinologist visits remained unchanged. Annual healthcare costs per patient increased post-intervention.

CONCLUSIONS

The diabetes specialist nurse intervention positively impacted glycemic control and healthcare utilization, particularly through increased remote consultations. Despite higher healthcare costs, the intervention improved access to care and patient engagement. Further research is needed to assess the long-term sustainability and cost-effectiveness of such interventions.

摘要

背景

本研究评估糖尿病专科护士干预对糖尿病患者临床结局和医疗保健利用的影响。

方法

对2019年至2022年的452名患者队列进行观察。在干预前后分析了诸如糖化血红蛋白(HbA1C)水平和体重指数(BMI)等临床指标以及医疗保健利用模式。该干预主要在2019冠状病毒病大流行期间进行。

结果

糖化血红蛋白水平有适度降低,尽管这一变化无统计学意义。远程就诊于初级保健医生的次数显著增加,反映出向远程医疗的转变。干预并未显著改变体重指数值,尽管患者队列老龄化且疾病进展,但该值仍保持稳定。然而,面对面就诊略有下降,而就诊于糖尿病专科医生和内分泌科医生的次数保持不变。干预后每位患者的年度医疗保健成本增加。

结论

糖尿病专科护士干预对血糖控制和医疗保健利用产生了积极影响,特别是通过增加远程会诊。尽管医疗保健成本较高,但该干预改善了医疗服务可及性和患者参与度。需要进一步研究来评估此类干预的长期可持续性和成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6f9/12070680/3445eb8619db/12912_2025_3074_Fig1_HTML.jpg

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