The effects of complications and comorbidities on the quality of preventive diabetes care: a literature review.
The effects of complications and comorbidities on the quality of preventive diabetes care: a literature review.
复制标题
并发症和合并症对预防性糖尿病护理质量的影响：文献综述。
DOI：
10.1089/pop.2007.0017
复制
发表时间：
2008
影响因子：
2.5
通讯作者：
Boult,Chad
中科院分区：
文献类型：
--
作者：
Conwell,LeslieJackson;Boult,Chad
尽管并发症和合并症等并发症在糖尿病患者中很常见，但在糖尿病预防护理质量的研究中常常忽略这两种情况。这项对糖尿病预防护理质量文献的系统回顾不仅评估了并发症和合并症的报告和调整趋势，还评估了当前并发症和合并症衡量标准的局限性。本次审查确定了 34 项研究，其中通过过程措施评估了糖尿病预防护理的质量，并报告了并发症或合并症。这些研究通常会确定某些并发症或合并症的存在，计算并发症或合并症，或使用合并症指数来衡量发病率。虽然早期的研究报告了并发症或合并症的患病率，但最近的研究使用并发症或合并症作为回归模型中的协变量。尽管取得了这一进展，但并发症和合并症对护理过程的影响尚不清楚，因为并发症和合并症测量之间存在交叉研究差异，而且很少有研究探讨并发症和合并症的独立影响。有效的并发症和合并症测量对于评估糖尿病预防护理的质量是必要的，特别是对于患有并发疾病的患者。目前报告的并发症和合并症的测量可能无法解决与质量相关的结构，这强调需要一种比现有文献中记录的方法更好的方法。 （人口健康管理。
Although concurrent conditions such as complications and comorbidities are common in people with diabetes, both are often omitted from studies of the quality of diabetes preventive care. This systematic review of the literature on the quality of diabetes preventive care assesses not only trends in the reporting of and adjusting for complications and comorbidities, but also the limitations of current measures of complications and comorbidities.This review identified 34 studies in which the quality of diabetes preventive care was assessed with process measures and complications or comorbidities were reported. More often than not, the studies identified the presence of certain complications or comorbidities, counted complications or comorbidities, or used comorbidity indices to measure morbidity. While earlier studies reported the prevalence of complications or comorbidities, more recent studies use complications or comorbidities as covariates in regression models. Despite this progress, the effects of complications and comorbidities on care processes are unclear because of cross-study variation among measures of complications and comorbidities and because very few studies address the independent effects of complications and comorbidities.Effective measures of complications and comorbidity are necessary to evaluate the quality of diabetes preventive care, particularly for patients with concurrent conditions. Current reported measures of complications and comorbidities may not address constructs related to quality, underscoring the need for a methodology that is better than the approaches now documented in the literature. (Population Health Management.