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Aten Primaria ; 51(1): 18-23, 2019 01.
Artículo en Español | MEDLINE | ID: mdl-29477546

RESUMEN

INTRODUCTION: The assessment of the Diabetes Mellitus 2 Care Process (PAI-DM2) through the assessment tool for the chronic illness' care models (IEMAC-Diabetes) allows the design of health interventions for the improvement of medical care. OBJECTIVE: Analysing the quality of healthcare provided to DM2 patients. DESIGN: Quasiexperimental study before and after intervention with a not randomised control group. LOCATION: Health care district of primary care Sevilla. PARTICIPANTS: 12 groups of ascribed patients, 5 Primary Care Healthcenter, chosen in a discretionary way. INTERVENTION: Physicians and nurses from the 12 intervention groups took part in a training program, including an external rotation in the Diabetes Daycare Hospital. MAIN MEASUREMENTS: Number of included patients, glycated hemoglobin, feet exploration (FE), and ocular fundus (OF). RESULTS: 1,475 DM-2 patients were analysed. The proportion of included patients per group was 8.5%, 45.5% were women. At the beginning of the study, the rate of patients with HbA1c<7% were 38.9% in 2013 against 47.7% in 2014 and 40.2% in 2016; 33% of the patients had an OF in 2013 against 41.77% in 2014; 51.6% of patients had an EF against 54.7% in 2014. After the intervention, statistically significant differences were reached in HbA1c (p=0.01) and retinography requested (p=0.01). CONCLUSIONS: IEMAC-Diabetes allows spotting improvement areas in the PAI-DM2. The absence of statistically significant differences may be the result of contamination in the sample and/or Hawthorne effect.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Mejoramiento de la Calidad , Indicadores de Calidad de la Atención de Salud/normas , Estudios Controlados Antes y Después , Diabetes Mellitus Tipo 2/sangre , Femenino , Pie , Fondo de Ojo , Hemoglobina Glucada/análisis , Humanos , Masculino , Examen Físico , Retina/diagnóstico por imagen , España
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