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Continued improveme...
Continued improvement of metabolic control in Swedish pediatric diabetes care.
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- Samuelsson, Ulf, 1951- (author)
- Linköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus,Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Sweden
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- Åkesson, Karin (author)
- Jönköping University,The Jönköping Academy for Improvement of Health and Welfare,Department of Pediatrics, County Hospital Ryhov, Jönköping, Sweden,Cty Hosp Ryhov, Sweden; Jonkoping Univ, Sweden
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- Peterson, Anette (author)
- Jönköping University,The Jönköping Academy for Improvement of Health and Welfare,Jonkoping Univ, Sweden; Jonkoping Univ, Sweden
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- Hanås, Ragnar, 1951 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics
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- Hanberger, Lena, 1957- (author)
- Linköpings universitet,Avdelningen för omvårdnad,Medicinska fakulteten,Region Östergötland, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus,Division of Nursing, Department of Medicine and Health Sciences, Linköping University, Sweden
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(creator_code:org_t)
- 2016-11-03
- 2018
- English.
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In: Pediatric Diabetes. - : John Wiley & Sons. - 1399-543X .- 1399-5448. ; 19:1, s. 150-157
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Abstract
Subject headings
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- BACKGROUND: To prospectively investigate if the grand mean HbA1c and the differences in mean HbA1c between centers in Sweden could be reduced, thereby improving care delivered by pediatric diabetes teams.METHODS: We used an 18-month quality improvement collaborative (QIC) together with the Swedish pediatric diabetes quality registry (SWEDIABKIDS). The first program (IQ-1), started in April 2011 and the second (IQ-2) in April 2012; together they encompassed 70% of Swedish children and adolescents with diabetes.RESULTS: The proportion of patients in IQ-1 with a mean HbA1c <7.4% (57 mmol/mol) increased from 26.4% before start to 35.9% at 36 months (P < .001), and from 30.2% to 37.2% (P < .001) for IQ-2. Mean HbA1c decreased in both participating and non-participating (NP) centers in Sweden, thereby indicating an improvement by a spatial spill over effect in NP centers. The grand mean HbA1c decreased by 0.45% (4.9 mmol/mol) during 36 months; at the end of 2014 it was 7.43% (57.7 mmol/mol) (P < .001). A linear regression model with the difference in HbA1c before start and second follow-up as dependent variable showed that QIC participation significantly decreased mean HbA1c both for IQ-1 and IQ-2. The proportion of patients with high HbA1c values (>8.7%, 72 mmol/mol) decreased significantly in both QICs, while it increased in the NP group.CONCLUSIONS: The grand mean HbA1c has decreased significantly in Sweden from 2010 to 2014, and QICs have contributed significantly to this decrease. There seems to be a spatial spill-over effect in NP centers.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Keyword
- diabetes mellitus type 1
- hemoglobin A1c protein
- human
- pediatrics
- quality of health care
Publication and Content Type
- ref (subject category)
- art (subject category)
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