The Quality of Primary Diabetes Care in the Bangkok Metropolitan Administration: Case Study of a Public Health Center

Abstract

This descriptive study was conducted for the purpose of describing the quality of primary diabetes care in a public health center in the Bangkok Metropolitan Administration. Survey data was collected for 4 months, from May to August 2010. A total of 165 diabetic patients completed a researcher-designed questionnaire for the purpose of obtaining information on the care processes received from care providers. Patients’ Fasting Plasma Glucose (FPG) reports were obtained from the public health center to assess diabetic care outcomes. The data were analyzed using descriptive statistics and Pearson’s Product Moment Correlation. Only 10.3% of the patients met the glycemic control goal (FPG ≤ 126 mg%). The findings revealed that 90.9 % of the patients demonstrated improper preventive care. Only 2.4% had annual foot examinations, 10.3% of the patients received aspirin treatment, 12.7% had HbA1C testing and 24.8% had annual retinal examinations. More than half of patients had complications: 35.7% had hypertension and 20.0% had heart disease. The results demonstrated that health promotion and continuity of care were the strength of diabetes care in public health centers and that they increased positive outcomes. Proper process for diabetes care was found to suggest an increase in positive outcomes, even though a wide gap exists between practice recommendations and the prevention and continuity of diabetes care in Bangkok. Thus, a need for primary diabetes care practice guideline development, with a supportive system to encourage physicians in using those guidelines, along with diabetes care system reform in public health centers is evident.