mHealth糖尿病干预对血糖控制的影响卡塔尔世界杯8强波胆分析医疗保健利用分析%A Quinn,Charlene C %A Swasey,Krystal K %A Torain,Jamila M %A Shardell,Michelle D %A Terrin,Michael L %A Barr,Erik A %A Gruber-Baldini,Ann L %+马里兰大学医学院流行病学与公共卫生学系，红木街660 W, Howard Hall Suite 200，马里兰州巴尔的麦市，21201，美国，1410706 2406，cquinn@som.umaryland.edu %K集群随机临床试验%K卫生保健%K卫生服务利用率%K mHealth %K 2型糖尿病%D 2018 %7 15.10.2018 %9背景:2型糖尿病(T2D)是一种主要的慢性疾病，需要通过改变生活方式和推荐的卫生服务就诊进行管理。移动医疗(mHealth)是一种鼓励自我管理的有前途的工具，但很少有研究调查移动医疗对医疗保健利用的影响。目的:本分析的目的是确定2年医疗服务使用率的变化，以及使用率是否解释了移动糖尿病干预研究(MDIS)中1年内糖化血红蛋白(HbA1c)绝对下降1.9%。方法:我们使用了2006年至2010年的商业索赔数据，这些数据与美国马里兰州26个初级保健诊所的登记患者病历数据相关。56%(92/163)的参与者可获得二次索赔数据分析。在最初的MDIS研究中，招募了医生，并随机分配到常规护理和3种日益复杂的干预措施中的1种。患者遵循医师随机分配。分析中的主要变量包括按服务类型划分的卫生服务利用情况和HbA1c变化。 The claims data was aggregated into 12 categories of utilization to assess change in 2-year health service usage, comparing rates of usage pre- and posttrial. We also examined whether utilization explained the 1.9% decrease in HbA1c over 1 year in the MDIS cluster randomized clinical trial. Results: A significant group by time effect was observed in physician office visits, general practitioner visits, other outpatient services, prescription medications, and podiatrist visits. Physician office visits (P=.01) and general practitioner visits (P=.02) both decreased for all intervention groups during the study period, whereas prescription claims (P<.001) increased. The frequency of other outpatient services (P=.001) and podiatrist visits (P=.04) decreased for the control group and least complex intervention group but increased for the 2 most complex intervention groups. No significant effects of utilization were observed to explain the clinically significant change in HbA1c. Conclusions: Claims data analyses identified patterns of utilization relevant to mHealth interventions. Findings may encourage patients and health providers to discuss the utilization of treatment-recommended services, lab tests, and prescribed medications. Trial Registration: ClinicalTrials.gov NCT01107015; https://clinicaltrials.gov/ct2/show/NCT01107015 (Archived by Webcite at http://www.webcitation.org/72XgTaxIj) %M 30322839 %R 10.2196/10776 %U http://mhealth.www.mybigtv.com/2018/10/e10776/ %U https://doi.org/10.2196/10776 %U http://www.ncbi.nlm.nih.gov/pubmed/30322839