Survey and audit of the standard of care of diabetic patients in the community of east Dorset
Survey and audit of the standard of care of diabetic patients in the community of east Dorset
Results: 51 practices in East Dorset were approached about this project. 45 (88%) agreed to complete the structure questionnaire. Of these, 37 (i.e. 72.5% of the original 51) agreed to a practice visit. A total of 3974 diabetic patients' notes were reviewed, out of 4130 diabetics identified. Overall prevalence of diabetes was 1.61%. 14.2% of patients were over 80. Male: female ratio was 1.2:1, overall. Average duration of the disease was about 9 years, at the time of review. The structure questionnaire showed deficiencies in audit facilities, particularly; also in the completeness of diabetic registers, and in the use of optometrists and chiropodists. Process criteria analysis, (for GP follow-up patients only), showed that, within the last 13 months, 44% of patients had a record of a full eye examination, 25% a serum cholesterol measurement, 50% smoking status, and 57% some foot inspection. Over 75% of patients had their glycaemic control (blood glucose, HbA1c/fructosamine) and their blood pressure measured. Outcome criteria analysis was done for all diabetic patients, including those under hospital follow-up. This showed that, in those patients in which the measurement has been done, average HbA1c was 8.07%, any degree of retinopathy to be present in 17.3%, hypertension in 27%, and hypercholesterolaemia in 33%. Tests for statistical association, at a practice level, showed evidence of an association between the presence of a detailed diabetic register and some process criteria, but not with any outcome criteria. Practices with higher percentages of process measurements done were not statistically associated with better average outcome.
These results compare well with other published surveys of diabetic care. Nonetheless, there are some follow-up criteria that need special attention, (e.g. control of blood pressure and cholesterol). There is a lack of correlation between the highly organised practices and better outcome criteria.
University of Southampton
Dunn, Nicholas Raymond
a1486936-8711-4b9b-9e1c-1b6415575b45
1998
Dunn, Nicholas Raymond
a1486936-8711-4b9b-9e1c-1b6415575b45
Dunn, Nicholas Raymond
(1998)
Survey and audit of the standard of care of diabetic patients in the community of east Dorset.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
Results: 51 practices in East Dorset were approached about this project. 45 (88%) agreed to complete the structure questionnaire. Of these, 37 (i.e. 72.5% of the original 51) agreed to a practice visit. A total of 3974 diabetic patients' notes were reviewed, out of 4130 diabetics identified. Overall prevalence of diabetes was 1.61%. 14.2% of patients were over 80. Male: female ratio was 1.2:1, overall. Average duration of the disease was about 9 years, at the time of review. The structure questionnaire showed deficiencies in audit facilities, particularly; also in the completeness of diabetic registers, and in the use of optometrists and chiropodists. Process criteria analysis, (for GP follow-up patients only), showed that, within the last 13 months, 44% of patients had a record of a full eye examination, 25% a serum cholesterol measurement, 50% smoking status, and 57% some foot inspection. Over 75% of patients had their glycaemic control (blood glucose, HbA1c/fructosamine) and their blood pressure measured. Outcome criteria analysis was done for all diabetic patients, including those under hospital follow-up. This showed that, in those patients in which the measurement has been done, average HbA1c was 8.07%, any degree of retinopathy to be present in 17.3%, hypertension in 27%, and hypercholesterolaemia in 33%. Tests for statistical association, at a practice level, showed evidence of an association between the presence of a detailed diabetic register and some process criteria, but not with any outcome criteria. Practices with higher percentages of process measurements done were not statistically associated with better average outcome.
These results compare well with other published surveys of diabetic care. Nonetheless, there are some follow-up criteria that need special attention, (e.g. control of blood pressure and cholesterol). There is a lack of correlation between the highly organised practices and better outcome criteria.
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Published date: 1998
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Local EPrints ID: 463527
URI: http://eprints.soton.ac.uk/id/eprint/463527
PURE UUID: 0f8dd06b-26db-4202-86f3-a69b1a0fd016
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Date deposited: 04 Jul 2022 20:53
Last modified: 23 Jul 2022 01:09
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Author:
Nicholas Raymond Dunn
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