Factors associated with the effectiveness of diabetes care at primary care settings

Abstract

Objective: To assess the effectiveness of diabetes care and the factors associated with the effectiveness at primary care settings. Material and Method: Data were obtained from reviewing of 1,795 medical patient files of patients with type 2-DM treated at forty-eight primary care settings. Information recorded included characteristics, body mass index, co-morbidity, fasting blood glucose (FBG) and HbA 1c levels and health personnel mix types (physicians, pharmacists, nurses, health technical officers and community health workers). HbA 1c level of diabetes in 542 of 1,795 medical patient files were analyzed. Glycemic controllability of diabetes patients was defined using FBG and HbA 1c levels as the effectiveness indicators of diabetes care. Results: Of 1,795 patients, 40.8% were able to control their FBG levels and 22.7% of the 542 patients who have HbA1c data could control their HbA 1c levels. Multivariate analysis confirmed that age and health personnel mix types are significant factors for glycemic controllability as measured by FBG level (p < 0.01). By measuring HbA 1c level, age was also significant factor in diabetes care effectiveness (p = 0.012). Conclusion: Age was a significant factor in controlling both FBG and HbA 1c levels in type 2 diabetes whereas health personnel, physicians and pharmacists, are significant factors in increasing effectiveness of diabetes care. The policy makers should consider distributing these health personnel to primary care settings and this would be a challenge for the policy makers to develop such a strategy and to implement this policy.