Family Practices Achievement of Diabetes Quality of Care Targets and Risk of Screen-Detected Diabetic Retinopathy 英文参考文献.docVIP

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Family Practices Achievement of Diabetes Quality of Care Targets and Risk of Screen-Detected Diabetic Retinopathy 英文参考文献.doc

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Family Practices Achievement of Diabetes Quality of Care Targets and Risk of Screen-Detected Diabetic Retinopathy 英文参考文献

FamilyPractices’AchievementofDiabetesQualityof CareTargetsandRiskofScreen-DetectedDiabetic Retinopathy MartinC.Gulliford1*,HitenDodhia2,SobhaSivaprasad3,MarkAshworth1 1DivisionofHealthandSocialCareResearch,King’sCollegeLondon,London,UnitedKingdom,2DepartmentofPublicHealth,LambethNHSPrimaryCareTrust,London, UnitedKingdom,3OphthalmologyDepartment,King’sCollegeHospital,London,UnitedKingdom Abstract Background:Weaimedtodeterminewhetherfamilypractices’achievementofdiabetesqualityofcaretargetsisassociated withdiabeticretinaldiseaseinregisteredpatients. Methods:Dataforachievementofdiabetesqualityofcaretargets,includingtheproportionofpatientswithHbA1c#7.5%, for144familypracticesinLondonUK,fortheyears2004/5to2007/8,werelinkedtodatafromapopulation-baseddiabetes eyescreeningprogrammecollectedfromSeptember2007toFebruary2009.Analyseswereadjustedforage,sex,duration andtypeofdiabetes,unadjusteddiabetesprevalence,ethnicityanddeprivationcategory. Results:Datawereanalysedfor24,458participantswithoneormoreeyescreeningresultsintheperiod.Therewere9,332 (38%)withanydiabeticretinopathyand2,819(11.5%)withsightthreateningdiabeticretinopathy(STDR),including2,654 (10.9%) with maculopathy. Among participants registered at 13 family practices that were in the highest quartile for achievementoftheHbA1cqualityofcaretargetforallfouryearsofstudy,therelativeoddsofanydiabeticretinopathy were0.78(0.69to0.88)P,0.001.Forparticipantsat12practicesconsistentlyinthelowestquartileofHbA1cachievement, the relative odds of any diabetic retinopathy were 1.16 (1.03 to 1.30), P=0.015. In the highest achieving practices, the relativeoddsofmaculopathywere0.74(0.62to0.89),P=0.001andSTDR0.77(0.65to0.92),P=0.004. Conclusions:Theriskofdiabeticretinopathymightbeloweratfamilypracticesthatconsistentlyachievehighlyondiabetes qualityofcaretargetsforHbA1c. Citation:GullifordMC,DodhiaH,SivaprasadS,AshworthM(2010)FamilyPractices’AchievementofDiabetesQualityofCareTargetsandRiskofScreen-Detected DiabeticRetinopathy.PLoSONE5(4):