Applying the Diabetes Quality Improvement Project Indicators in the Indian Health Service primary care setting
Applying the Diabetes Quality Improvement Project Indicators in the Indian Health Service primary care setting
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DOI：
10.2337/diacare.24.1.22
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发表时间：
2001-01-01
期刊：
影响因子：
16.2
通讯作者：
Gohdes, D
中科院分区：
文献类型：
--
作者：
Acton, KJ;Shields, R;Gohdes, D
目的-随着糖尿病质量改善项目（DQIP）措施的出版，印度卫生服务国家糖尿病计划应用DQIP格式的IHS糖尿病护理和成果审计的比较和benchmarks.Research设计和方法-自1986年以来，IHS糖尿病护理和成果审计已进行了病历审查，在>75%的IHS和部落设施。每年从当地糖尿病登记处抽取系统随机样本。图表审查由经过培训的专业人员根据标准定义和说明进行。提取的数据输入到一个基于微机的流行病学软件包。为每个项目构建本地、区域和国家费率。在1995-1997年期间，有150个设施提交了数据供汇编，代表了所有12个IHS行政区的参与情况。IHS糖尿病护理和结果审计收集了几乎所有的DQIP措施，除了低密度脂蛋白胆固醇（在1998年被添加到记录审查）。结果-在1995年，1996年和1997年，总共有9,557，9,985，和9,626个人，分别包括在总IHS审计样本。1995年、1996年和1997年的回顾显示，在所有受试者中，分别有55%、65%和80%的受试者在这一年中进行了一次以上的HbA（1c）检测（P < 0.001）;分别有42%、38%和34%的人有高危HbA（1c）（>9.5%）（P < 0.001）;分别有83%、81%和84%的患者进行了大量蛋白尿检测分别有16%、17%和23%的患者检测了微量蛋白尿（P < 0.001）;分别有80%、81%和85%的患者检测了总胆固醇（P < 0.001），
OBJECTIVE - With publication of the Diabetes Quality Improvement Project (DQIP) measures, the Indian Health Service National Diabetes Program applied the DQIP format to its IHS Diabetes Care and Outcomes Audit for comparison and benchmarks.RESEARCH DESIGN AND METHODS - since 1986 the IHS Diabetes Care and Outcomes Audit has been conducted by medical record review in >75% of IHS and tribal facilities. Each year systematic random sample of charts is drawn from local diabetes registries. Chart reviews are conducted by trained professionals according to standard definitions and instructions. Abstracted data are entered into a microcomputer-based epidemiologic software package. Local, regional, and national rates are constructed for each item. During the period 1995-1997, 150 facilities submitted data for compilation, representing participation from all 12 IHS administrative regions. The IHS Diabetes Care and Outcomes Audit collected virtually all of the DQIP measures, with the exception of LDL cholesterol (which was added to the record review in 1998).RESULTS - In 1995, 1996, and 1997, a total of 9,557, 9,985, and 9,626 individuals, respectively, were included in the total IHS audit sample. The reviews for 1995, 1996, and 1997 revealed that of all subjects: 55, 65, and 80%, respectively, had more than one HbA(1c) test during the year (P < 0.001); 42, 38, and 34%, respectively, had a high-risk HbA(1c) (>9.5%) (P < 0.001); 83, 81, and 84%, respectively, were tested for macroproteinuria (P < 0.11) and 16, 17, and 23%, respectively, were tested for microproteinuria (P < 0.001); total cholesterol was assessed in 80, 81, and 85%, respectively (P < 0.001), and corresponding proportions of those with values