Risikostratificering af patienter med diabetes mellitus

Translated title of the contribution: Risk stratification of patients with diabetes mellitus

Peter Qvist, Dorte Glintborg, Alin Andries, Christian Hansen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

INTRODUCTION: This paper discusses the optimal distribution of responsibility between general practitioners (GPs) and hospitals for follow-up of patients with chronic diseases. We investigated a set of risk stratification criteria developed to optimize specialist shared care for patients with diabetes mellitus. MATERIAL AND METHODS: We included patients with diabetes from the catchment areas of four diabetes out-patient clinics in southern Denmark. Patients were risk-stratified to 3 follow-up levels (level 1 - follow-up only by their GP, level 2 - intensified follow-up by GP and/or shared care schemes, level 3 - follow-up only in out-patient clinics). The results were subsequently compared with the patients' actual follow-up status. RESULTS: A total of 647 patients (563 type 2 diabetes and 84 type 1 diabetes) were included from 15 GPs. Among these, 139 were stratified to level 1, 409 to level 2 and 99 to level 3. A total of 444 patients were actually being followed by their GP, 129 in shared care and 74 in out-patient clinics. The frequency of out-patient and shared care control varied from 13% to 39% between the four centres. CONCLUSION: Patients generally had a higher risk profile than anticipated. The model could select high-risk patients to be followed in specialized out-patient clinics. The model was less suitable for patients with low or moderate risk, and it should be modified before its general introduction.
Udgivelsesdato: 2008-Oct-6
Original languageDanish
JournalUgeskrift for læger
Volume170
Issue number41
Pages (from-to)3235-8
Number of pages3
ISSN0041-5782
Publication statusPublished - 6. Oct 2008

Keywords

  • Denmark
  • Diabetes Complications
  • Diabetes Mellitus, Type 1
  • Diabetes Mellitus, Type 2
  • Family Practice
  • Follow-Up Studies
  • Humans
  • Outpatient Clinics, Hospital
  • Quality Assurance, Health Care
  • Risk Assessment
  • Risk Factors

Cite this

Qvist, Peter ; Glintborg, Dorte ; Andries, Alin ; Hansen, Christian. / Risikostratificering af patienter med diabetes mellitus. In: Ugeskrift for læger. 2008 ; Vol. 170, No. 41. pp. 3235-8.
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Risikostratificering af patienter med diabetes mellitus. / Qvist, Peter; Glintborg, Dorte; Andries, Alin; Hansen, Christian.

In: Ugeskrift for læger, Vol. 170, No. 41, 06.10.2008, p. 3235-8.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Risikostratificering af patienter med diabetes mellitus

AU - Qvist, Peter

AU - Glintborg, Dorte

AU - Andries, Alin

AU - Hansen, Christian

PY - 2008/10/6

Y1 - 2008/10/6

N2 - INTRODUCTION: This paper discusses the optimal distribution of responsibility between general practitioners (GPs) and hospitals for follow-up of patients with chronic diseases. We investigated a set of risk stratification criteria developed to optimize specialist shared care for patients with diabetes mellitus. MATERIAL AND METHODS: We included patients with diabetes from the catchment areas of four diabetes out-patient clinics in southern Denmark. Patients were risk-stratified to 3 follow-up levels (level 1 - follow-up only by their GP, level 2 - intensified follow-up by GP and/or shared care schemes, level 3 - follow-up only in out-patient clinics). The results were subsequently compared with the patients' actual follow-up status. RESULTS: A total of 647 patients (563 type 2 diabetes and 84 type 1 diabetes) were included from 15 GPs. Among these, 139 were stratified to level 1, 409 to level 2 and 99 to level 3. A total of 444 patients were actually being followed by their GP, 129 in shared care and 74 in out-patient clinics. The frequency of out-patient and shared care control varied from 13% to 39% between the four centres. CONCLUSION: Patients generally had a higher risk profile than anticipated. The model could select high-risk patients to be followed in specialized out-patient clinics. The model was less suitable for patients with low or moderate risk, and it should be modified before its general introduction. Udgivelsesdato: 2008-Oct-6

AB - INTRODUCTION: This paper discusses the optimal distribution of responsibility between general practitioners (GPs) and hospitals for follow-up of patients with chronic diseases. We investigated a set of risk stratification criteria developed to optimize specialist shared care for patients with diabetes mellitus. MATERIAL AND METHODS: We included patients with diabetes from the catchment areas of four diabetes out-patient clinics in southern Denmark. Patients were risk-stratified to 3 follow-up levels (level 1 - follow-up only by their GP, level 2 - intensified follow-up by GP and/or shared care schemes, level 3 - follow-up only in out-patient clinics). The results were subsequently compared with the patients' actual follow-up status. RESULTS: A total of 647 patients (563 type 2 diabetes and 84 type 1 diabetes) were included from 15 GPs. Among these, 139 were stratified to level 1, 409 to level 2 and 99 to level 3. A total of 444 patients were actually being followed by their GP, 129 in shared care and 74 in out-patient clinics. The frequency of out-patient and shared care control varied from 13% to 39% between the four centres. CONCLUSION: Patients generally had a higher risk profile than anticipated. The model could select high-risk patients to be followed in specialized out-patient clinics. The model was less suitable for patients with low or moderate risk, and it should be modified before its general introduction. Udgivelsesdato: 2008-Oct-6

KW - Denmark

KW - Diabetes Complications

KW - Diabetes Mellitus, Type 1

KW - Diabetes Mellitus, Type 2

KW - Family Practice

KW - Follow-Up Studies

KW - Humans

KW - Outpatient Clinics, Hospital

KW - Quality Assurance, Health Care

KW - Risk Assessment

KW - Risk Factors

M3 - Tidsskriftartikel

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EP - 3238

JO - Ugeskrift for Laeger

JF - Ugeskrift for Laeger

SN - 0041-5782

IS - 41

ER -