在退伍军人卫生管理局内的糖尿病视网膜病变查的地理差异
Melanie Davis1, Molly J E Snider2, Kelly J Hunt3
1Charleston Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson VA Medical Center, 109 Bee Street, Charleston, SC 29401, USA.
Primary care diabetes
|July 7, 2023
概括
地理位置显著影响退伍军人糖尿病视网膜病变查的坚持. 视力障碍患者的查率在各个地区有很大差异,突出了影响这种视力障碍患者获得护理和资源分配的未测量因素.
科学领域:
- 眼科医生 眼科 眼科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 糖尿病视网膜病变 (DR) 是工作年龄成人视力损失的主要原因.
- 退伍军人卫生管理局 (VA) 在2006年实施了用于DR查的远视网膜成像.
- 自1998年以来,VA内的DR查遵守率的国家数据一直是有限的.
研究的目的:
- 调查地理位置对VA内的糖尿病视网膜病变查依从性的影响.
- 为了分析DR查率在不同VA医疗中心的采集区的变化.
主要方法:
- 利用国家VA电子医疗记录对940,654名糖尿病退伍军人的队列.
- 分析了2年的查遵守情况,考虑了125个VA流域.
- 调整以人口统计,并发症,HbA1c,药物使用和获取指标为准.
主要成果:
- 总的来说,74%的符合条件的退伍军人在两年内在VA内接受了DR查.
- 在DR查患病率中观察到显著的地理差异,在VA流域范围内从27%到86%不等.
- 即使调整了多个临床和人口因素,这些差异仍然存在.
结论:
- 在VA流域中DR查遵守率的广泛差异表明未测量的决定因素.
- 这些发现对于为临床决策提供信息和优化DR查计划的资源配置至关重要.
- 解决地理差异对于改善糖尿病退伍军人的眼睛健康结果至关重要.
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