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紧急部门在黑人糖尿病患者中使用
Barry Rovner1, Robin Casten2, Ginah Nightingale3
1Departments of Neurology, Psychiatry, and Ophthalmology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.
Diabetes spectrum : a publication of the American Diabetes Association
|November 20, 2023
概括
对患有糖尿病的黑人进行的一项新干预措施并没有减少急诊室的访问. 慢性疾病和医生信任度低等因素与住院病例有关,这表明需要进行系统性改变.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 糖尿病管理 糖尿病管理
- 健康差异 在健康上的差异
背景情况:
- 糖尿病不成比例地影响黑人,导致急诊室 (ED) 使用率更高.
- 现有干预措施需要对不同人群的有效性进行评估.
研究的目的:
- 为了比较糖尿病专业间团队加强对医疗护理的坚持 (DM I-TEAM) 干预与常规医疗保健 (UMC) 在预防与糖尿病相关的ED访问和住院治疗的有效性.
- 为了确定与糖尿病黑人患者的经常性ED访问和住院相关的基线因素.
主要方法:
- 一项随机对照试验涉及200名患有糖尿病的黑人.
- 该DM I-TEAM干预包括糖尿病教育,行为激活,远程医疗和药剂师建议.
- 通常医疗保健 (UMC) 作为对照组.
主要成果:
- 在12个月内,DM I-TEAM和UMC组之间,与糖尿病相关的ED访问或住院住院的回归没有显著差异.
- 复诊的相关因素包括糖尿病持续时间更长,更多的慢性疾病,以前的ED/住院,抗胆固醇负担以及医生满意度/信任度较低.
- 所有确定的因素都具有统计学意义 (P ≤0.05).
结论:
- 在预防与糖尿病相关的ED访问或黑人患者住院治疗方面,DM I-TEAM干预措施并不优于UMC.
- 高度的医疗病率,药物负担和不良的医生患者关系是不良事件的关键驱动因素.
- 解决医疗保健障碍,医生关系和社区能力的系统级变化对于改善结果至关重要.
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