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首页> 外文期刊>Scandinavian journal of primary health care. >The impact of primary care organization on avoidable hospital admissions for diabetes in 23 countries
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The impact of primary care organization on avoidable hospital admissions for diabetes in 23 countries

机译：基层医疗机构对23个国家的可避免的糖尿病患者住院治疗的影响

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Objective: Diabetes is a so-called ambulatory care sensitive condition. It is assumed that by appropriate and timely primary care, hospital admissions for complications of such conditions can be avoided. This study examines whether differences between countries in diabetes-related hospitalization rates can be attributed to differences in the organization of primary care in these countries. Design: Data on characteristics of primary care systems were obtained from the QUALICOPC study that includes surveys held among general practitioners and their patients in 34 countries. Data on avoidable hospitalizations were obtained from the OECD Health Care Quality Indicator project. Negative binomial regressions were carried out to investigate the association between characteristics of primary care and diabetes-related hospitalizations. Setting: A total of 23 countries. Subjects: General practitioners and patients. Main outcome measures: Diabetes-related avoidable hospitalizations. Results: Continuity of care was associated with lower rates of diabetes-related hospitalization. Broader task profiles for general practitioners and more medical equipment in general practice were associated with higher rates of admissions for uncontrolled diabetes. Countries where patients perceive better access to care had higher rates of hospital admissions for long-term diabetes complications. There was no association between disease management programmes and rates of diabetes-related hospitalization. Hospital bed supply was strongly associated with admission rates for uncontrolled diabetes and long-term complications. Conclusions: Countries with elements of strong primary care do not necessarily have lower rates of diabetes-related hospitalizations. Hospital bed supply appeared to be a very important factor in this relationship. Apparently, it takes more than strong primary care to avoid hospitalizations.Key pointsCountries with elements of strong primary care do not necessarily have lower rates of diabetes-related avoidable hospitalization.Hospital bed supply is strongly associated with admission rates for uncontrolled diabetes and long-term complications.Continuity of care was associated with lower rates of diabetes-related hospitalization.Better access to care, broader task profiles for general practitioners, and more medical equipment in general practice was associated with higher rates of admissions for diabetes.
机译：目的：糖尿病是所谓的非卧床护理敏感性疾病。假定通过适当和及时的初级保健，可以避免因此类情况而住院。这项研究检验了各国之间糖尿病相关住院率的差异是否可以归因于这些国家的初级保健组织的差异。设计：关于初级保健系统特征的数据来自QUALICOPC研究，该研究包括对34个国家的全科医生及其患者进行的调查。可避免住院的数据来自经合组织医疗质量指标项目。进行了负二项式回归，以调查初级保健特征与糖尿病相关住院之间的关联。地点：共有23个国家。受试者：全科医生和患者。主要结局指标：与糖尿病有关的可避免的住院治疗。结果：持续护理与糖尿病相关的住院率较低有关。全科医师的任务范围更广，全科医师使用更多的医疗设备，与糖尿病失控的住院率更高有关。患者认为获得更好护理的国家因长期糖尿病并发症而住院的比率更高。疾病管理计划与糖尿病相关住院率之间没有关联。医院病床的供应与不受控制的糖尿病和长期并发症的入院率密切相关。结论：拥有强大基础保健服务的国家不一定会降低与糖尿病相关的住院率。医院床位供应似乎是这种关系中非常重要的因素。显然，要避免住院需要的不仅是强大的初级保健。要点拥有强大初级保健要素的国家不一定会降低与糖尿病有关的可避免住院率。并发症;护理的持续性与糖尿病相关的住院率较低有关;获得更好的护理，全科医生的工作任务更广泛以及在常规实践中使用更多的医疗设备与较高的糖尿病住院率相关。

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