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National Healthcare Quality Report - part 4

Tiếp nhận dịch vụ bệnh tiểu đường được khuyến nghị NHQR sử dụng một biện pháp tổng hợp để theo dõi tỷ lệ quốc gia nhận của tất cả các biện pháp can thiệp bệnh tiểu đường được đề nghị: một hemoglobin A1c hàng năm kiểm tra, kiểm tra một mắt, và kiểm tra một chân. | o m in Findings Management Receipt of Three Recommended Diabetes Services The NHQR uses a composite measure to track the national rate of the receipt of all three recommended diabetes interventions an annual hemoglobin A1c test an eye examination and a foot examination. These provide an assessment of the management of diabetes and the presence of possible complications that can occur. They are basic process measures for the quality of care for diabetes. They do not include outcomes such as the hemoglobin A1c value an indicator of whether or not diabetes is adequately controlled. Figure 2.8. Adults age 40 and over with diagnosed diabetes who received at least one HbA1c test retinal exam and foot exam in the past year 2000-2004 -o Total all 3 - - Retinal exam recommended services Source Agency for Healthcare Research and Quality Medical Expenditure Panel Survey 2000-2004. Reference population Civilian noninstitutionalized population with diagnosed diabetes age 40 and over. Note Rates are age adjusted. Data include persons with both type 1 and type 2 diabetes. Of adults age 40 and over diagnosed with diabetes 46.7 received an HbA1c test a retinal exam and a foot exam in 2004 compared with 41.2 in 2000. The rate was statistically unchanged between 2000 and 2004 Figure 2.8 . From 2000 to 2004 the rate of receipt of foot exams for adults age 40 and over diagnosed with diabetes increased from 65.4 to 71.5 while the rates for HbA1c tests and retinal exams remained stable. 40 National Healthcare Quality Report o i m in Prevention Lower Extremity Amputations Although diabetes is the leading cause of lower extremity amputations amputations can be avoided through proper care on the part of patients and providers. Hospital admissions for lower extremity amputations for patients with diagnosed diabetes reflect poorly controlled diabetes. Better management of diabetes would prevent the need for lower extremity amputations. Figure 2.9. Hospital admissions for lower extremity .