背景:本研究的主要目的是调查卢瓦尔河中心(CVDL)地区糖尿病患者糖尿病视网膜病变的眼科筛查率。这项研究其次旨在确定与常规眼科筛查相关的因素。
方法:数据来自法国国家医疗保健数据库(SNDS)。根据抗糖尿病药物的报销确定个人。在2015年至2016年期间被确定为至少接受过一次眼科检查的患者被认为是定期随访。
结果:总计,在SNDS中确定了118,181名居住在CVDL的糖尿病患者,74,048人接受了眼科筛查。2015年至2016年,眼科检查率为62.7%,在该地区差异很大(从Loiret的65.6%到Cher的54.0%)。与定期眼科筛查相关的主要因素是:与已建立的初级保健医生进行随访(OR=2.88),定期随访糖尿病专家(OR=2.14),并与内科医生定期随访(OR=1.57)。
结论:这项研究表明,CVDL地区糖尿病患者的糖尿病视网膜病变的眼科筛查可以得到明显改善,特别是在农村地区。影响随访依从性的因素是多方面的,但似乎主要与患者的整体医疗管理质量有关。这些发现强调了公共卫生政策的必要性,以通过促进糖尿病个体的全面医疗来改善糖尿病视网膜病变的发现和预防。
BACKGROUND: The main objective of this study was to investigate the rate of ophthalmological screening for diabetic retinopathy in diabetic individuals in the Centre-Val de Loire (CVDL) region. This study secondarily aimed to identify factors associated with regular ophthalmological screening.
METHODS: Data were extracted from the French national healthcare database (SNDS). Individuals were identified on the basis of reimbursements for antidiabetic medications. Patients who were identified as having at least one reimbursed eye examination between 2015 and 2016 were considered as having regular follow-up.
RESULTS: In total, 118,181 diabetic individuals residing in CVDL were identified in the SNDS, and 74,048 had undergone ophthalmological screening. The rate of eye examination was 62.7% between 2015 and 2016 and was highly variable within the region (from 65.6% in Loiret to 54.0% in Cher). The main factors associated with regular eye screening were: follow-up with an established primary care physician (OR=2.88), regular follow-up with a diabetologist (OR=2.14), and regular follow-up with an internist (OR=1.57).
CONCLUSIONS: This study suggests that ophthalmological screening for diabetic retinopathy in individuals with diabetes in the CVDL region could be significantly improved, particularly in rural areas. Factors influencing compliance with follow-up are multiple but appear mainly related to the patients\' quality of overall medical management. These findings highlight the need for public health policies to improve detection and prevention of diabetic retinopathy by promoting comprehensive medical care for diabetic individuals.