Quality of care of type II diabetic patients at Abu Khalifa family medicine center, Ismailia, Egypt

Abstract EN

Introduction : Diabetes is a chronic illness thai require continuing tncdieal care.

Patient health education and solC management aimes to prevent acute complications and to reduce tlic risk of long tern complications.

Diabolic care is a complex proccss and require many issues beyond slycemic control.

This study was conducted to assess quality ol diabetic care at Abou Khalifa Family Medicine Center and to determine some factors that may affcct quality of this care.

Methodology: 1، is a descriptive cross-scctional study.

The target population were all diabetic patients (Type 2) meet the inclusion criteria and registered in the center.

The structure of diabetic care was assessed by two checklists, the first checklist is for the essential iiciius of carc (thirteen items) and the second one is for the less essential items (ten items).

The indicators of ilie process off diabetic care was assessed by a scoring system depends Qfl ten items for standard diabetic care by the priitcaie physicians in the past year.

Assessment of outcome was undertaken according to the national quality assurance j)rolocol and includes : the degree of diabetic control, obesity, smoking among the diabetic patients and control of blood pressure.

Another questionnaire was designed to determine iaetors that may affect quality of care and related to patients knowledge and attiwdcs and 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.

Statistical Package (or Social Science (SPSS) was used for data entry and statistical analysis.

Clii 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 is slili fare beyond our expectation as regards structure of care (lack of coordination with hospital, absent of appointment system and recall of defaulters are barriers to optimal care).

Assessment of the process of care showed that there is still poor recording in 34% of cases, pulse and sensory examination is not recorded in 45% of cases, foot examination is not recorded in 54% ol cases, fundus examination is not recorded in 66% and crcatininc & glycosylatcd Hb arenit recorded in 90%.

The outcome indicators showed that patient knowledge about diabetes is poor in 35% of cases, uncontrolled DM in 40% of cases, obesity in 68.5% and control of blood pressure is not achieved in 40% of cases.

Factors that may affect quality of care including good process ot care which is associated with better control if fastins blood sugar, good doctor- patient relationship ihai determine good process of care and contribute to control of blood pressure, pat icnl knowledge and attitude, and patient satisfaction.

Conclusion: We tccd more to do for diahciic patients as regards structure, process and outcome.

We must reeognize that good process of care, good doctorpttieni mclationship, patient knowledge and patient satisfaction arc i mponantdetcrminants of diabetic patient care