Ascertainment of outpatient visits by patients with diabetes: The National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS)
Ascertainment of outpatient visits by patients with diabetes: The National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS)
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DOI：
10.1016/j.jdiacomp.2015.03.019
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发表时间：
2015-07-01
影响因子：
3
通讯作者：
Herman, William H.
中科院分区：
文献类型：
--
作者：
Asao, Keiko;McEwen, Laura N.;Herman, William H.
目的：估计和评估提供者诊断代码和药物清单识别糖尿病患者门诊就诊的敏感性和特异性。方法：采用2006 ~ 2010年全国门诊医疗调查和全国医院门诊医疗调查数据。我们评估了提供者诊断和药物清单的敏感性和特异性，以识别糖尿病患者，使用糖尿病的复选框作为金标准。然后，我们使用多变量逻辑回归模型检查患者特征在敏感性方面的差异。结果：该复选框在用于分析的70352次就诊中确定了12647例糖尿病成人门诊就诊。提供者诊断或列出的糖尿病药物的敏感性和特异性分别为72.3% （95% CI: 70.8% ~ 73.8%）和99.2%（99.1% ~ 99.4%）。75岁以上的糖尿病患者，女性，非西班牙裔，以及那些有私人保险或医疗保险的人更有可能被医生的诊断和药物清单遗漏。有更多诊断代码和药物记录的糖尿病患者，有血糖或糖化血红蛋白A1c测量，或去办公室而不是医院门诊就诊的糖尿病患者更不容易被遗漏。结论：提供者的诊断代码和药物清单无法识别大约四分之一的糖尿病患者门诊就诊。(C) 2015爱思唯尔公司版权所有。
Aims: To estimate and evaluate the sensitivity and specificity of providers' diagnosis codes and medication lists to identify outpatient visits by patients with diabetes.Methods: We used data from the 2006 to 2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. We assessed the sensitivity and specificity of providers' diagnoses and medication lists to identify patients with diabetes, using the checkbox for diabetes as the gold standard. We then examined differences in sensitivity by patients' characteristics using multivariate logistic regression models.Results: The checkbox identified 12,647 outpatient visits by adults with diabetes among the 70,352 visits used for this analysis. The sensitivity and specificity of providers' diagnoses or listed diabetes medications were 72.3% (95% CI: 70.8% to 73.8%) and 99.2% (99.1% to 99.4%), respectively. Diabetic patients >= 75 years of age, women, non-Hispanics, and those with private insurance or Medicare were more likely to be missed by providers' diagnoses and medication lists. Diabetic patients who had more diagnosis codes and medications recorded, had glucose or hemoglobin A1c measured, or made office- rather than hospital-outpatient visits were less likely to be missed.Conclusions: Providers' diagnosis codes and medication lists fail to identity approximately one quarter of outpatient visits by patients with diabetes. (C) 2015 Elsevier Inc. All rights reserved.