美国预防护理服务的趋势 被诊断为糖尿病的成年人,2008-2020年
Jacob T Wittman1, Kai McKeever Bullard1, Stephen R Benoit1
1Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA.
Diabetes care
|October 16, 2023
概括
糖尿病的预防护理仍然停滞不前,大多数推服务在2008-2019年期间没有任何改善. 流感疫苗接种增加,但某些群体的牙科和胆固醇检查等其他服务下降.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 预防性护理服务对于管理糖尿病和预防并发症至关重要.
- 美国糖尿病协会建议针对最佳糖尿病管理提供特定服务.
- 了解这些服务的普及趋势对于公共卫生倡议至关重要.
研究的目的:
- 分析了接受美国糖尿病协会推的6项关键预防护理服务的趋势,这些服务适用于已诊断为糖尿病的美国成年人.
- 为了确定2008年至2020年期间服务利用的变化.
- 检查不同的人口和保险子组的趋势.
主要方法:
- 采用了来自医学支出小组调查 (2008-2020) 对25616名美国成年糖尿病患者的横截面数据.
- 计算了接受特定服务的成年人比例:牙科检查,扩展眼检查,足部检查,胆固醇测试,A1C测试和流感疫苗.
- 雇员加入点回归分析从2008年到2019年的趋势.
主要成果:
- 在2008年至2020年期间,个人预防服务的总体接收率从32.6%到89.9%不等.
- 趋势基本上持平,只有流感疫苗接种有显著增加 (年变化2.6%).
- 小组分析显示了异质的趋势:流感疫苗接种和A1C测试的改善,但特定人群的胆固醇和牙科诊断下降.
结论:
- 在2008年至2019年期间,除了流感疫苗接种外,没有观察到使用大多数推的糖尿病预防护理服务的显著改善.
- 包括老年人,低学历者,医疗补助保险和无保险者在内的特定子组经历了基本服务的下降.
- 需要有针对性的干预措施,以改善糖尿病患者在服务不足的人群中获得和利用预防性护理.
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