The study of the outcomes of Diabetes Care: Using the example from Diabetes Shared Care of a regional hospital in Taitung .

• Main Authors: Yi-mei Huang, 黃憶玫
• Other Authors: Tzu-kuei Chang
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/33997587087313702348

碩士 === 慈濟大學 === 公共衛生研究所 === 96 === Background: In Taiwan, the diabetes shared-care program has developed for many years. Recent researches showed the intervention can be effective way of improving glycemic control and increasing frequency of performance of relevant laboratory tests. But data on long-term quality of diabetes care are lacking. Among Taitung population, there are both the greatest proportion of aborigines and aged people and higher prevalence and mortality comparing to the rest parts of Taiwan. However there is few researches addressing on efficacy and associated factors of diabetes care among Taitung population. Objective: To assess the efficacy and associated factors of diabetes shared-care program for type 2 diabetic patients among Taitung population. Methods: In the retrospective study we enrolled 242 type 2 diabetic patients of a Taitung regional hospital, who participated in diabetes shared-care program and completed 4 follow-up times from January 2003 to December 2004. Data of demographics, outcome indicator: mean HbA1c value , and performance indicators : frequency of performance in HbA1c, lipid profile, serum creatinine, urine analysis and fundus exam were collected within the 3-year period. Results:(1) There is higher frequency of five performance indicators than that of previous researches in Taiwan. The greatest reduction in mean HbA1c value was detected during the first follow-up year, then it is progressively increasing by time (baseline,1st,2nd ,3rd year is 9.12%,7.93%,8.20% ,8.27%). The outcome indicator is still significantly improved at the end of a 3-year period. (2) The longer duration, comorbidity and relative medication used had higher frequency of performance indicators. Also aged < 65 years old, aborigines, higher initial mean HbA1c value, longer duration might contributed to poor glycemic control. Conclusions: Our study demonstrated the long-term efficacy of diabetes shared- care program and baseline characteristic (age , ethnic , initial HbA1c value and duration ) were associated factors of diabetes care. These findings can help evaluate the quality of diabetes-care among Taitung population.