PDB85 Effectiveness of Community-Hospital-Integrated Diabetes Management System in Shanghai Minhang District

Abstract

OBJECTIVES: The objective was to measure the effectiveness of the information system based community-hospital-integrated diabetes management system in Shanghai Minhang district, as well as to analyze the factors influencing the effectiveness of the system. METHODS: The study was based on the information system from the community-hospital-integrated diabetes management program established in Shanghai Minhang district since 2007. The effectiveness of communityhospital- integrated diabetes management system was examined. Logistic regression model was employed to analyze the influencing factors. RESULTS: There were 43,709 diabetes patients managed during the study period from October 2008 to September 2009, including Type1 diabetes (T1DM), Type2 diabetes (T2DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) patients. Among the patients who had at least two follow-up visits during the study period, 2.95% IGT patients and 2.34% of IFG patients turned into diagnosed diabetes status. Within one-year diabetes management, the percentage of patients with ideal blood sugar rose from 20.59% to 28.10% according to fasting plasma glucose (FPG) test results. The percentage of patients who monitored blood sugar regularly rose from 77.90% to 83.27%. The percentage of patients who did not exercise reduced from 46.24% to 45.31%. The percentage of patients who monitored diet completely according to doctor's suggestion rose from 80.83% to 82.31%. Regression analysis showed that over 50 years old, taking heavy exercises, attending group follow-ups and door-to-door follow-ups (compared to outpatient follow-up visit) were the factors with positive impact on maintaining ideal blood sugar level. Over 7-year disease duration, overweight, and obesity had negative impact on blood sugar maintaining. CONCLUSIONS: The conversion rates from IGT and IFG to diabetes were both relatively low under the community-hospital-integrated diabetes management system in Shanghai Minhang district. The performances in blood sugar control and self-management have been improved during one-year study period. Effectiveness of group follow-up and door-to-door follow-up are superior to that of out-patient follow-up visit.