Does a 2.5-year self-management education and support intervention change patterns of healthcare use in African-American adults with type 2 diabetes?
Does a 2.5-year self-management education and support intervention change patterns of healthcare use in African-American adults with type 2 diabetes?
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2.5 年的自我管理教育和支持干预是否会改变患有 2 型糖尿病的非裔美国成人的医疗保健使用模式？
DOI：
10.1111/dme.12374
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Tang,TS
中科院分区：
文献类型：
--
作者：
Yeung,RO;Oh,M;Tang,TS
目的调查为期2.5年的糖尿病自我管理教育和支持干预对医疗保健利用的影响，并分析与医疗利用模式相关的因素。方法我们招募了60名非裔美国人2型糖尿病患者，他们完成了为期2.5年的基于赋权的糖尿病自我管理教育和支持干预。初级卫生保健使用结果包括急性护理就诊、非急性护理就诊和残疾损失天数。急性护理是根据紧急护理就诊、急诊科就诊和住院的频率计算的综合分数。非急性护理测量了预定门诊就诊的频率。为了检验医疗保健使用模式的变化，我们比较了干预前6个月和干预后6个月期间的医疗保健就诊频率。结果在急性护理、非急性护理或残疾损失天数方面，医疗保健使用模式没有发现显著变化。多元回归模型发现，抑郁程度越高(P=0.001)，非急性医疗就诊次数越多，糖尿病病程越长(P=0.019)，舒张压水平越低(P=0.025)，因残疾而失去的天数越少。结论在我们的样本中，参加长期糖尿病自我管理教育和支持干预对非裔美国人的医疗保健使用没有影响。
AimsTo investigate the impact of a 2.5‐year diabetes self‐management education and support intervention on healthcare use and to examine factors associated with patterns of healthcare use.MethodsWe recruited 60 African‐American adults with Type 2 diabetes who completed a 2.5‐year empowerment‐based diabetes self‐management education and support intervention. Primary healthcare use outcomes included acute care visits, non‐acute care visits and days lost to disability. Acute care was a composite score calculated from the frequency of urgent care visits, emergency department visits and hospitalizations. Non‐acute care measured the frequency of scheduled outpatient visits. To examine change in patterns of healthcare use, we compared the frequency of healthcare visits over the 6‐month period preceding the intervention with that in the last 6 months of the intervention.ResultsNo significant changes in patterns of healthcare use were found for acute care, non‐acute care or days lost to disability. Multiple regression models found higher levels of depression (P=0.001) to be associated with a greater number of non‐acute healthcare visits, and found longer duration of diabetes (P=0.019) and lower levels of diastolic blood pressure (P=0.025) to be associated with fewer days lost to disability.ConclusionsParticipation in a long‐term diabetes self‐management education and support intervention had no impact on healthcare use in our sample of African‐American subjects.