tailieunhanh - báo cáo khoa học: " Short- and long-term effects of a quality improvement collaborative on diabetes management"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Short- and long-term effects of a quality improvement collaborative on diabetes management | Schouten et al. Implementation Science 2010 5 94 http content 5 1 94 Implementation Science IMPLEMENTATION SCIENCE RESEARCH ARTICLE Open Access Short- and long-term effects of a quality improvement collaborative on diabetes management Loes MT Schouten1 Marlies EJL Hulscher2 Jannes JE van Everdingen3 Robbert Huijsman4 Louis W Niessen5 6 Richard PTM Grol2 Abstract Introduction This study examined the short- and long-term effects of a quality improvement collaborative on patient outcomes professional performance and structural aspects of chronic care management of type 2 diabetes in an integrated care setting. Methods Controlled pre- and post-intervention study assessing patient outcomes hemoglobin A1c cholesterol blood pressure weight blood lipid levels and smoking status professional performance guideline adherence and structural aspects of chronic care management from baseline up to 24 months. Analyses were based on 1 861 patients with diabetes in six intervention and nine control regions representing 37 general practices and 13 outpatient clinics. Results Modest but significant improvement was seen in mean systolic blood pressure decrease by mm Hg versus mm Hg and mean high density lipoprotein levels increase by versus points at two-year follow up. Positive but insignificant differences were found in hemoglobin A1c cholesterol and blood lipid levels. The intervention group showed significant improvement in the percentage of patients receiving advice and instruction to examine feet and smaller reductions in the percentage of patients receiving instruction to monitor blood glucose and visiting a dietician annually. Structural aspects of self-management and decision support also improved significantly. Conclusions At a time of heightened national attention toward diabetes care our results demonstrate a modest benefit of participation in a multi-institutional quality improvement collaborative focusing on integrated .

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