TY -的AU -奎因,Charlene C盟——Swasey克里斯托K AU - Torain,贾米拉•米非盟- Shardell,米歇尔·D AU - Terrin迈克尔•L AU -巴尔Erik盟——Gruber-Baldini安L PY - 2018 DA - 2018/10/15 TI -一个mHealth糖尿病血糖控制干预:医疗利用率分析乔- JMIR mHealth Uhealth SP - e10776六世- 6 - 10 KW -集群随机临床试验KW -医疗保健千瓦卫生服务利用率KW - mHealth KW - 2型糖尿病AB -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健康服务就诊进行管理。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。将索赔数据汇总为12类利用情况，以评估2年医疗服务使用情况的变化，并比较试验前后的使用率。 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) SN - 2291-5222 UR - http://mhealth.www.mybigtv.com/2018/10/e10776/ UR - https://doi.org/10.2196/10776 UR - http://www.ncbi.nlm.nih.gov/pubmed/30322839 DO - 10.2196/10776 ID - info:doi/10.2196/10776 ER -