1887
Volume 2011, Issue 1
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

ملخص

Introduction: Diabetes mellitus is a chronic illness that requires continuous medical care. Patient health education and self-management aim to prevent acute complications and to reduce the risk of long-term complications. Care of diabetic patients is a complex process and requires many issues beyond glycemic control. This study is conducted to assess quality of care of diabetic patients in the diabetic clinic at Al Wakra Healthcare Center and to determine some factors that may affect the quality of this care.

Methodology: This is a descriptive, cross-sectional study. The target population was all diabetic patients (Type 2) that meet the inclusion criteria and registered at the center. Two checklists assessed the structure of diabetic care; the first checklist is for the essential items of care (thirteen items) and the second one is for the less essential items (ten items). The indicators of the process of diabetic care was assessed by a scoring system that depends on ten items for standard diabetic care by the primary care physicians in the past year. Assessment of the outcome was done according to an international quality assurance protocol and it includes: the degree of diabetic control, obesity, smoking among the diabetic patients and control of blood pressure. We added HbA1c to this list. Another questionnaire was designed to determine factors that may affect quality of diabetic care-related to patient's knowledge and attitude and it is divided into 4 sections: personal data, patient knowledge about diabetes, patient attitude toward care and clinical and biochemical assessments. A pilot study was carried out to test the questionnaires. Epi-info. Six statistical package was used for data entry and statistical analysis. Chi square or Fisher exact tests were used to test the significance, and P value <  0.05 was considered significant.

Results: The study showed that diabetic care at Primary Healthcare Centers (PHC) in Qatar represented by Al Wakra Primary Healthcare Center is better when compared to the care in other studies in different countries. 86.7% of physicians show that most of the structure items are good to fair except for the absence of chiropodist and identification cards for diabetic patients. Assessment of the process of care showed that there is good to fair recording in 91.75% of cases; foot examination is not recorded in most of cases; and fundus examination is not recorded in 31.7%. The outcome indicators showed that patient knowledge about diabetes is poor in 35% of cases, uncontrolled FBS in 75.6% of cases, uncontrolled HbA1 c in 57.8%; obesity in 63.5% and control of blood pressure is not achieved in 49% of cases.

Conclusion: Diabetic Clinic at Al Wakra Primary Healthcare Center provides good care for diabetic patients in terms of structure, process and outcome; however, more efforts are needed for refining these services.

Loading

جارٍ تحميل قياسات المقالة...

/content/journals/10.5339/qmj.2011.1.11
٢٠١١-٠٦-٠١
٢٠٢٤-٠٧-١٣
Loading full text...

Full text loading...

References

  1. http/www.ncqo.org/dprp/dqip2.html. Diabetes Quality improvement project initial measure set (final version) 26/2/2007,1.
  2. Clark CM Jr, Chin MH, Davis SN, Walker CA. Incorporating diabetes research into clinical practice celebrating 25 years of diabetes training centre. Diabetes Care. 2007; 24::21342142.
    [Google الباحث العلمي]
  3. http/www.pop health wisc.edu/uw phi/publication/forums/brantes pdf. Transparency and pay for performance: Building a real business care for better quality health care by Francis de Brantes, M.B.A. program leader, Health care initiatives. GE corporate health care and medical services. 26/2/2007:1.
  4. McGlynn EA, Asch SM, Adams H, Decrestofaro A, Ken EA. The quality of health care delivered to adults in the United States. New England Journal of Medicine. 2003; 348:26:26352645.
    [Google الباحث العلمي]
  5. Streja DA, Rabkin SW. Factors associated with implementation of preventive care measures in patients with diabetes mellitus. Arch Intern Med. 1999; 159::294302.
    [Google الباحث العلمي]
  6. Chin MH, Zhang JX, Merrell K. Diabetes in the African-American Medicare population: morbidity, quality of care, and resource utilization. Diabetes Care. 2001; 21::10901095.
    [Google الباحث العلمي]
  7. Wagner EH, Grothans LC, Sandhu N, Galrin MS, McGregor M, Artz K, Coleman EA. Chronic care clinics for diabetes in primary care: A system-wide randomized trial. Diabetes Care. 2001; 24::695700.
    [Google الباحث العلمي]
  8. Sandur CN, Moline N, Costa M, Michelik D, Mendlowitz D, Rollers S, Watson R, Swain BE, Selby JV, Javorski WC. Diabetes management in a health maintenance organization: Efficacy of care management using cluster visits. Diabetes Care. 1999; 22::20112017.
    [Google الباحث العلمي]
  9. Ruoff G, Grayl S. Using a flow sheet to improve performance in treatment of elderly patients with type 2 diabetes. Earn Med. 1999; 31::331336.
    [Google الباحث العلمي]
  10. Aubert RE, Herman WH, Waters J, Moore IN, Sutton D, Peterson BL, Baily CM, Kaplan JP. Nurse case management to improve glycemic control in diabetic patients in a health maintenance organization: A randomized, controlled trial. Ann Int Med. 1999; 129::605612.
    [Google الباحث العلمي]
  11. Buckley B. Ashville project: A special report pharmacy time (supple). 1998;:331.
    [Google الباحث العلمي]
  12. Norris SL, Engelgan KM. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 2001; 24::561587.
    [Google الباحث العلمي]
  13. Ellrod G, Cook DJ, Lee J, Cho M, Hunt D, Weingarten S. Evidence based disease management. JAMA. 1997; 278::16871692.
    [Google الباحث العلمي]
  14. Sidoror J, Shell R, Harris R. Does diabetes disease management save money and improve outcomes? A report of simultaneous short-term savings and quality improvement associated with a health maintenance organization sponsored disease management program among patients fulfilling health employer data and information set criteria. Diabetes Care. 2002; 25::684689.
    [Google الباحث العلمي]
  15. Zgibor R, Songer TJ. External Barriers to Diabetes Care: Addressing personal and health systems issues. Diabetes Spectr. 2001; 14::2328.
    [Google الباحث العلمي]
  16. Srinivasan M, Przybylski M, Swiegnosici S. Predictors of office based diabetic quality of care. Diabetes Care. 2001; 24::262267.
    [Google الباحث العلمي]
  17. Khattab M, Abolfotuh M, Alakiga W, Humaidi M, Al Joky M, Al Kaldi Y. Audit of Diabetes care in an academic family practice centre in Asir Region, Saudi Arabia. Diabetes research. 1996; 31::243254.
    [Google الباحث العلمي]
  18. Chesover D, Tudor Ml, Helton S. Survey and audit of diabetes care in general practices in South London. Br. J. Gen Prac. 1991; 41::282285.
    [Google الباحث العلمي]
  19. The scientific Committee of Quality Assurance in Primary Health Care Manual 1995. WHO-EM/PHC/81-A/G/93,199-223..
  20. Fabiyi AK, Kolawole BA. Adenfehitio. The impact of knowledge attitude, practices and beliefs of type 2 Nigerian diabetic patients on drug compliance. Diabetes international. 2002; V12:1, March.
    [Google الباحث العلمي]
  21. Chin MH, Cook S, Jin L, Drom ML, Harrison JF, Koppert J. Barriers to providing diabetes care in community health centres. Diabetes Care. 2001; 24::268274.
    [Google الباحث العلمي]
  22. Donabedian A. Exploration in quality assessment and monitoring. Vol 1. Ann. Arbor. Michigan: Health Administration Press 1980;:328.
    [Google الباحث العلمي]
  23. Abdulmajeed A, Salem M, El Deib A, Abdel Rahman M. Quality of care of Type 2 Diabetic patients at Abu Khalifa FM Center, Ismailia-Egypt. Suez Canal University Medical Journal. 2004; 7:1, March.
    [Google الباحث العلمي]
  24. Khattab M, Abolfotuh M, Alakiga W, Humaidi M, Al Toky M, Al Kaldi Y. Audit of Diabetes care in an Academic Family Practice Center in Asir Region Saudi Arabia. Diabetes research. 1996; 31::243254.
    [Google الباحث العلمي]
  25. Day GL. Diabetes education. In: Pickup JCWilliams G, eds. Textbook of diabetes. Oxford: Blackwell scientific publication 1991;:933939.
    [Google الباحث العلمي]
  26. Qureshi RH, Alowayyed A. An audit of the process of diabetic care in large family practice in Riyadh, Saudi Med. Journal. 1994; 16:5:394397.
    [Google الباحث العلمي]
  27. Chesover D, Tudor MI, Helton S. Survey and audit of diabetes care in general practices in South London. Br. J. Gen. Prac. 1991; 41::282285.
    [Google الباحث العلمي]
  28. Larme AC, Bugh JA. Attitudes of primary care providers toward diabetes: Barriers to guidelines implementation. Diabetes care. 1998; 21::13911396.
    [Google الباحث العلمي]
  29. Hughes D. Consultation length and outcome in two group general practices. Journal of the Royal College of General Practitioners. 1983; 33::143147.
    [Google الباحث العلمي]
  30. Butler J, Calnan Nl. Too many patients? A study of the economy of time and standards' of care in general practice. England. Avebury: Gower Publishing Company 1987.
    [Google الباحث العلمي]
  31. Streja DA, Kabkin SW. Factors associated with implementation of preventive care measurs in patients with diabetes mellitus. Arch Intern. Med. 1999; 159::294302.
    [Google الباحث العلمي]
  32. 2003;. Kamel M. Predictors ofself-care behaviour in adults with type 2 diabetes in Abo Khalifa village. MSc. Thesis, Suez Canal U, 71-80.
  33. Salman K. A study of the effect of an education program to family physicians on their management capacity in diabetes mellitus. MD thesis. Family Medicine, Suez Canal University, 2000: 82-87.
  34. Colos C. Diabetes education: letting the patient into the picture. Practical diabetes. 1990; 7::110112.
    [Google الباحث العلمي]
  35. Kelly JA, Ray S, Stephen R. Applying the diabetes quality improvement project indicators in the Indian health service in primary care setting. Diabetes care. 2001; 24::2226.
    [Google الباحث العلمي]
/content/journals/10.5339/qmj.2011.1.11
Loading
  • نوع المستند: Research Article

الأكثر اقتباسًا لهذا الشهر Most Cited RSS feed

هذه الخانة مطلوبة
يُرجى إدخال عنوان بريد إلكتروني صالح
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error