题名

The Effectiveness of Hospital-Based Diabetes Case Management: An Example from a Northern Taiwan Regional Hospital

并列篇名

醫院式糖尿病個案管理成效研究－以北台灣某區域醫院為例

作者

張煥禎(Huan-Cheng Chang)；張玉坤(Yue-Cune Chang)；李淑美(Su-Mei Lee)；陳美芳(Mei-Fang Chen)；黃美菁(Mei-Ching Huang)；彭竟琳(Chin-Lin Peng)；顏慶雲(Ching-Yun Yan)

关键词

糖尿病 ； 醫院式個案管理 ； 區域醫院 ； diabetes ； hospital-based case management ； regional hospital

期刊名称

The Journal of Nursing Research

卷期/出版年月

15卷4期（2007 / 12 / 01）

页次

296 - 309

内容语文

英文
中文摘要

The aim of this study was to design, implement and evaluate disease outcomes at a regional hospitalbased case management program of care for patients with type 2 diabetes. Amedical team and practice guidelines were established in line with the health insurance strategy of Taiwan's Bureau of National Health Insurance (BNHI) and American Diabetes Association (ADA) Standards of Care for Diabetes (2003 edition). Also, a set of self-care booklets was designed suitable for use by the subject group. The study was prospective and followed the patients from enrollment to one year. Patient outcomes were determined based on laboratory examinations and recorded self-care behavior. Data were collected at enrollment and over 4 follow-up times within a one year period. Generalized Estimating Equation (GEE) multiple linear regression and logistic regression were used for repeated measurements and adjustments of the effects of specific prognostic factors. Sixty subjects diagnosed with type 2 diabetes (mean duration 3.25 years) were recruited. All participants were married with a mean age of 52.5 years. A majority (58.3%) was male and 65% were ethnic Hakka. Self-care knowledge and behavior accomplishment rates were: taking medications by oneself, 91.3% (knowing medicines, 25.4%); hypoglycemia management, 23.3%; monitoring blood sugar, 46.7%; exercise, 35.8%; diet management, 51.7% and foot care, 92.8%. Significantly improved ADA diabetes care standard items included HbA1C (p＜.0001), fasting glucose (p＜.01) and triglycerides (p＜.05). The study incorporated evidence-based guidelines, public health insurance strategies and self-care booklets into a protocol to provide comprehensive care. The implemented diabetes program achieved diabetes care goals and improved patient self-care.
英文摘要

The aim of this study was to design, implement and evaluate disease outcomes at a regional hospitalbased case management program of care for patients with type 2 diabetes. Amedical team and practice guidelines were established in line with the health insurance strategy of Taiwan's Bureau of National Health Insurance (BNHI) and American Diabetes Association (ADA) Standards of Care for Diabetes (2003 edition). Also, a set of self-care booklets was designed suitable for use by the subject group. The study was prospective and followed the patients from enrollment to one year. Patient outcomes were determined based on laboratory examinations and recorded self-care behavior. Data were collected at enrollment and over 4 follow-up times within a one year period. Generalized Estimating Equation (GEE) multiple linear regression and logistic regression were used for repeated measurements and adjustments of the effects of specific prognostic factors. Sixty subjects diagnosed with type 2 diabetes (mean duration 3.25 years) were recruited. All participants were married with a mean age of 52.5 years. A majority (58.3%) was male and 65% were ethnic Hakka. Self-care knowledge and behavior accomplishment rates were: taking medications by oneself, 91.3% (knowing medicines, 25.4%); hypoglycemia management, 23.3%; monitoring blood sugar, 46.7%; exercise, 35.8%; diet management, 51.7% and foot care, 92.8%. Significantly improved ADA diabetes care standard items included HbA1C (p＜.0001), fasting glucose (p＜.01) and triglycerides (p＜.05). The study incorporated evidence-based guidelines, public health insurance strategies and self-care booklets into a protocol to provide comprehensive care. The implemented diabetes program achieved diabetes care goals and improved patient self-care.
主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
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被引用次数
  1. 陳都文、王俊毅(2009)。糖尿病共同照護網對偏遠地區中老年患者健康狀況之成效。臺灣公共衛生雜誌，28(4)，334-343。
  2. 黃憶玫、張慈桂(2011)。糖尿病照護成效與影響因素之探討：以台東某區域醫院糖尿病共同照護網為例。臺灣公共衛生雜誌，30(1)，19-28。
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