A long-term quality-of-care score for predicting the occurrence of macrovascular diseases in patients with type 2 diabetes mellitus
| Autor: | How Ran Guo, Jian Nan Wang, Pi I. Li |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors endocrine system diseases Endocrinology Diabetes and Metabolism Taiwan Type 2 diabetes 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Diabetes mellitus Internal Medicine medicine Humans Longitudinal Studies 030212 general & internal medicine Aged Quality of Health Care Macrovascular disease Aged 80 and over Proportional hazards model business.industry Incidence Incidence (epidemiology) Medical record nutritional and metabolic diseases Type 2 Diabetes Mellitus General Medicine Middle Aged medicine.disease Confidence interval Diabetes Mellitus Type 2 Research Design Female business Diabetic Angiopathies |
| Zdroj: | Diabetes Research and Clinical Practice. 139:72-80 |
| ISSN: | 0168-8227 |
| DOI: | 10.1016/j.diabres.2018.02.027 |
| Popis: | Aims The aim of this study was to develop a long-term quality-of-care score to predict the occurrence of macrovascular diseases in patients with type 2 diabetes mellitus, on the basis of the hypothesis that good quality of care can reduce the risk of macrovascular complications. Methods Using Taiwan’s Longitudinal Cohort of Diabetes Patients Database and the medical records in a medical center, we identified the incident patients diagnosed with type 2 diabetes during 1999–2003 and followed them until 2011. A summary score (from 0 to 8) was calculated according to process indicators (frequencies of HbA1c and lipid profile testing and urine, foot and retinal examinations), intermediate outcome indicators (low-density lipoprotein, blood pressure and HbA1c), and the co-morbidity of hypertension. We used Cox regression models to evaluate the association between the score and the incidence of macrovascular complications. Results Of the 4275 patients enrolled, 1928 developed macrovascular complication events after a mean follow-up period of 8.2 years. Compared to the risk of developing a macrovascular disease event in patients with scores ≤1, the risk was 64% lower in those with quality-of-care scores ≥5 (adjusted hazard ratio = 0.36; 95% confidence interval: 0.28–0.45). Conclusions Good quality of care can reduce the risk of macrovascular diseases in patients with type 2 diabetes. The score developed in this study had a significant association with the risk of macrovascular complications and thus can be applied to guiding the care for these patients. |
| Databáze: | OpenAIRE |
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