Schulze J, Kunath H, Rothe U, Range U, Prettin C, Verlohren H J, Fischer S
Medizinische Klinik III, Universitätsklinikum Carl Gustav Carus Technische Universität Dresden.
Gesundheitswesen. 1996 Sep;58 Suppl 2:144-8.
After the societal change in the "New Federal States" of Germany Saxon diabetologists developed an integrated concept for care of diabetic patients: the Saxon Care Model (SCM). It aims at quality assurance in diabetes care and is based on services by cooperating general practitioners and specialists. This model was evaluated. First results were obtained describing the quality of care for 510 patients at baseline. This sample was collected at two specialized diabetologists (level 2), two specialized out-patient units at universities (level 2) and two general practitioners (level 1). The design of the study is a descriptive evaluation. Process and outcome quality at specialized and primary care units working according to the SCM is relatively high. HbA1c measurements were taken in order to quantify outcome quality. The results for primary as well as specialized care units ranged from acceptable to very good. They unfortunately cannot be generalized. The patients expressed that their quality of life was limited only scarcely. The presented preliminary results indicate a high effectiveness of the SCM with regard to relevant process-related outcome-variables. The large variance between single practices of both levels demonstrates that deficits in early diagnosis of diabetes-related complications still exist. On the other hand this points towards resources of quality improvement. The influence of quality assuring measures, e.g. quality circles, will be assessed in a three-year follow up.
在德国“新联邦州”的社会变革之后，萨克森州的糖尿病专家为糖尿病患者护理制定了一个综合概念：萨克森护理模式（SCM）。其旨在确保糖尿病护理质量，基于全科医生和专科医生合作提供的服务。该模式进行了评估。获得了初步结果，描述了510名患者基线时的护理质量。该样本来自两名专科糖尿病医生（二级）、两所大学的两个专科门诊单位（二级）和两名全科医生（一级）。该研究的设计是描述性评估。按照SCM运作的专科和初级护理单位的过程和结果质量相对较高。进行了糖化血红蛋白（HbA1c）测量以量化结果质量。初级和专科护理单位的结果从可接受到非常好不等。遗憾的是，这些结果不能一概而论。患者表示他们的生活质量几乎没有受到限制。所呈现的初步结果表明SCM在相关过程相关结果变量方面具有很高的有效性。两级单个医疗实践之间的巨大差异表明糖尿病相关并发症早期诊断方面的不足仍然存在。另一方面，这也指出了质量改进的资源。质量保证措施（如质量圈）的影响将在三年随访中进行评估。
