Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai Integration Model (SIM).
10.1007/s11684-021-0897-7
- Author:
Chun CAI
1
;
Yuexing LIU
1
;
Yanyun LI
2
;
Yan SHI
2
;
Haidong ZOU
3
,
4
;
Yuqian BAO
1
;
Yun SHEN
1
;
Xin CUI
5
;
Chen FU
6
;
Weiping JIA
7
Author Information
1. Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, National Office for Primary Diabetes Care, Shanghai Technical Center for Diabetes Prevention and Clinical Care, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, 200233, China.
2. Shanghai Municipal Center for Disease Control & Prevention, Shanghai, 200336, China.
3. Shanghai Eye Disease Prevention and Treatment Center/Shanghai Eye Hospital, Shanghai Key Laboratory of Ocular Fundus Diseases
4. Shanghai General Hospital, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200040, China.
5. Shanghai Municipal Health Commission Information Center, Shanghai, 200040, China.
6. Shanghai Municipal Center for Disease Control & Prevention, Shanghai, 200336, China. fuchen@scdc.sh.cn.
7. Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, National Office for Primary Diabetes Care, Shanghai Technical Center for Diabetes Prevention and Clinical Care, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, 200233, China. wpjia@sjtu.edu.cn.
- Collective Name:SIM Study Group
- Publication Type:Journal Article
- Keywords:
epidemiology;
macrovascular complication;
microvascular complication;
quality of care;
treatment pattern;
type 2 diabetes
- MeSH:
Aged;
Blood Pressure;
China/epidemiology*;
Cholesterol, LDL/therapeutic use*;
Cross-Sectional Studies;
Diabetes Mellitus, Type 2/drug therapy*;
Glycated Hemoglobin A/analysis*;
Humans;
Male;
Middle Aged
- From:
Frontiers of Medicine
2022;16(1):126-138
- CountryChina
- Language:English
-
Abstract:
This cross-sectional study aimed to investigate the quality of care of diabetes in Shanghai, China. A total of 173 235 patients with type 2 diabetes in 2017 were included in the analysis. Profiles of risk factors and intermediate outcomes were determined. The patients had a mean age of 66.43 ± 8.12 (standard deviation (SD)) years and a mean diabetes duration of 7.95 ± 5.53 (SD) years. The percentage of patients who achieved the target level for HbA1c (< 7.0%) was 48.6%. Patients who achieved the target levels for blood pressure (BP) < 130/80 mmHg and low-density lipoprotein-cholesterol (LDL-c) < 2.6 mmol/L reached 17.5% and 34.0%, respectively. A total of 3.8% achieved all three target levels, and the value increased to 6.8% with an adaptation of the BP target level (< 140/90 mmHg) for those over 65 years. Multivariable analysis identified the factors associated with a great likelihood of achieving all three target levels: male, young age, short diabetes duration, low body mass index, macrovascular complications, no microvascular complications, prescribed with lipid-lowering medication, and no prescription of antihypertensive medication. In conclusion, nearly 50% and one-third of the patients with diabetes met the target levels for HbA1c and LDL-c, respectively, with a low percentage achieving the BP target level. The percentage of patients who achieved all three target levels needs significant improvement.
