Sullivan F M, Stearn R, MacCuish A C
Department of General Practice, Glasgow University, UK.
Diabet Med. 1994 Jul;11(6):583-5. doi: 10.1111/j.1464-5491.1994.tb02040.x.
This study reports data from 50 practices (3550 patients) in Lanarkshire taking part in an audit of diabetes care. Data were obtained by review of general practitioner records and the correspondence from consultants and opticians contained in them. The principal study measures examine the process of care. Overall levels of performance were low: only 35.5% of patients had visual acuity and 54.5% fundoscopy recorded in the previous year. Significantly better results were observed for both examinations in those few practices which performed these examinations in more than 10% of their patients (51.4% vs 32.0% (mean difference 19.4, 95% CI 16.1-23.7) for visual acuity and 65.7% vs 53.3% (mean difference 12.4, 95% CI 3.0-21.8) for fundoscopy. Less than half of diabetic patients in Lanarkshire currently receive adequate screening for the ocular complications of diabetes. Most practices rely on hospital diabetic and ophthalmology services. Where practices undertake ocular examination of patients, this is currently in addition to those services provided elsewhere.
本研究报告了拉纳克郡参与糖尿病护理审核的50家医疗机构(3550名患者)的数据。数据通过查阅全科医生记录以及其中包含的顾问和验光师的通信获得。主要研究指标考察护理过程。总体表现水平较低:前一年仅有35.5%的患者进行了视力检查,54.5%的患者进行了眼底镜检查。在那些对超过10%的患者进行这些检查的少数医疗机构中,两项检查的结果明显更好(视力检查为51.4%对32.0%(平均差异19.4,95%可信区间16.1 - 23.7),眼底镜检查为65.7%对53.3%(平均差异12.4,95%可信区间3.0 - 21.8))。目前拉纳克郡不到一半的糖尿病患者接受了糖尿病眼部并发症的充分筛查。大多数医疗机构依赖医院的糖尿病和眼科服务。当医疗机构对患者进行眼部检查时,目前是在其他地方提供的服务之外额外进行的。