团队服务模式对芬兰北卡累利阿2型糖尿病患者的治疗过程、结果和医疗保健使用的影响

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes Pub Date : 2025-01-14 DOI:10.1016/j.pcd.2025.01.001

Marja-Leena Lamidi , Katja Wikström , Hilkka Tirkkonen , Päivi Rautiainen , Matias Laaninen , Tiina Laatikainen

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引用次数: 0

摘要

目标：在芬兰北卡累利阿，2020年期间在初级保健（PHC）中实施了基于团队的服务模式。在此模型中，医疗保健客户与立即启动服务流程的护士联系，护士可能会向客户咨询或指导客户咨询其他专业人员。评估了这种新的服务模式对2型糖尿病患者（T2D）的影响。方法：从电子健康记录中提取2016年诊断并于2023年仍居住在北卡累利阿的T2D患者（N = 6312）的数据。在2017年至2022年期间，考虑了与初级保健中心和专业医疗保健（SHC）的护士或医生的糖尿病相关接触，以及急诊护理接触，糖化血红蛋白（HbA1c）和低密度脂蛋白（LDL）的测量活动和水平。使用logistic和泊松混合模型分析了地区之间的年度差异。结果：以团队为基础的服务模式增加了与t2d相关的初级保健护士的远程接触，但最终减少到低于之前的水平。此外，其他接触的数量也减少了。它对HbA1c和LDL的测量活性或治疗水平没有影响。结论：团队服务模式可减少T2D患者的医疗接触次数，但其有效性和成本效益有待进一步验证。

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The effect of a team-based service model on treatment processes and outcomes and healthcare usage among people with type 2 diabetes in North Karelia, Finland

Aims

In North Karelia, Finland, a team-based service model was implemented in primary healthcare (PHC) during 2020. In this model, a healthcare customer contacts a nurse who initiates the service process immediately, possibly consulting or directing customers to other professionals. The effect of this new service model among patients with type 2 diabetes (T2D) was assessed.

Methods

Data from T2D patients diagnosed by 2016 and still residing in North Karelia in 2023 (N = 6312) were extracted from electronic health records. Diabetes-related contacts with nurses or physicians in PHC and specialised healthcare (SHC) were considered, along with emergency care contacts, measurement activity and levels of glycated haemoglobin (HbA1c) and low-density lipoproteins (LDL) between 2017 and 2022. Annual differences between areas were analysed using logistic and Poisson mixed models.

Results

The team-based service model increased T2D-related PHC remote contacts with nurses for a couple of years, but eventually they decreased to a lower level than before. Additionally, the number of other contacts reduced. It had no effect on measurement activity or treatment levels of HbA1c and LDL.

Conclusion

The team-based service model might reduce the number of healthcare contacts among T2D patients, but more evidence is needed on its effectiveness and cost-effectiveness.

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来源期刊

Primary Care Diabetes ENDOCRINOLOGY & METABOLISM-PRIMARY HEALTH CARE

CiteScore

5.00

自引率

3.40%

发文量

134

审稿时长

47 days

期刊介绍： The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.