Does availability of expanded point-of-care services improve outcomes for rural diabetic patients?

作者:Brown Megan; Kuhlman Dan; Larson Lance; Sloan Kara; Ablah Elizabeth*; Konda Kurt; Owings Christopher Scott
来源:Primary Care Diabetes, 2013, 7(2): 129-134.
DOI:10.1016/j.pcd.2013.01.008

摘要

Aims: The purpose of this study was to assess compliance with American Diabetes Association screening recommendations at Salina Family Healthcare (SFHC) in Salina, Kansas, a large rural town, and to evaluate the impact of point-of-care (POC) dilated eye exams for uninsured patients. POC exams are those performed in the location where patients are treated. %26lt;br%26gt;Methods: There were 462 type II diabetic (DM2) patients seen at SFHC in 2009 and 537 DM2 patients seen in 2010. A chart review of all patients with DM2 was done to assess rates of recommended screening exams, including dilated eye exams and foot exams. %26lt;br%26gt;Results: In 2009/2010 urine inicroalbumin was checked in 57%/75% of DM2 patients. HbA1c and low density lipoprotein (LDL) levels at goal were 46%/48% and 58%/58%, respectively. 47%/67% of DM@ patients received foot exams and 21%/30% received eye exams. In 2009,23% of the 155 uninsured diabetic patients at SFHC received a dilated eye exam. The following year, after implementation of on-site ophthalmologic services, rates of dilated eye exams increased 1.6 fold to 37% of the 196 uninsured patients. %26lt;br%26gt;Conclusions: SFHC performed similarly to national rates on some diabetic screening exams, but there is room for improvement in all recommended screening exams. The implementation of a novel approach to increasing dilated eye exam rates indicates that expanded POC services can improve outcomes for diabetic patients.

  • 出版日期2013-7