Regenstrief conference. Washington DC USA, 1994/12/11.
To identify key systems issues from the Indian Health Service (IHS) experience that must be addressed to improve metabolic control among patients with non-insulin-dependent diabetes mellitus (NIDDM) who were followed in primary care settings.
Records of diabetic patients seen in IHS facilities in specific geographic regions from 1987 to 1994.
A representative sample of charts from each facility was reviewed yearly to measure key variables.
The sampling frame was the number of diabetic patients currently active on the registry and the sample size calculated to measure a 10% change in selected practices at each facility.
Regional diabetes coordinators reviewed charts or trained local providers to sample and extract data in a standard format.
Regional data were examined to show trends in the performance of immunizations and foot examinations and in other variables such as hypertension and metabolic control.
The percentage of diabetic patients who received a single dose of pneumococcal vaccine improved from 24% in 1987 to 1988 to 57% in 1994 (P<0.01 for trend) among diabetic patients in Minnesota, Wisconsin, and Michigan.
Rates of yearly comprehensive foot examination increased from 36% to 58% (P<0.01 for trend) over the same period.
In Montana and Wyoming, the percentage of diabetic patients with uncontrolled hypertension (defined as the mean of three systolic blood pressure measurements of kap...
Mots-clés Pascal : Diabète non insulinodépendant, Système santé, Soin santé primaire, Amélioration, Inde, Asie, Homme, Endocrinopathie, Santé publique, Prise en charge
Mots-clés Pascal anglais : Non insulin dependent diabetes, Health system, Primary health care, Improvement, India, Asia, Human, Endocrinopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0165264
Code Inist : 002B21E01C. Création : 199608.