INVESTIGATING THE QUALITY OF CARE INDEX ASSOCIATED WITH DIABETIC PATIENTS COVERED BY URMIA RURAL PHYSICIAN IN 2017

Hosseini, M.H and Entezar Mahdi, R and Rasouli, J and Sadaghianifar, A (2019) INVESTIGATING THE QUALITY OF CARE INDEX ASSOCIATED WITH DIABETIC PATIENTS COVERED BY URMIA RURAL PHYSICIAN IN 2017. The Journal of Urmia University of Medical Sciences, 29 (10). pp. 726-735.

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Abstract

More than 382 million people in the world live with diabetes, 80% of whom live in low-income and developing countries. Today, it is quite clear that improving metabolic control in diabetic patients can reduce the complications of the disease. The purpose of this study was to evaluate the quality of care associated with diabetic patients under the coverage of Urmia rural family physician program in 2017. Materials & Methods: In this cross-sectional (descriptive-analytical) study, 257 rural diabetic patients under the coverage of Urmia city health center were selected through simple random sampling among the existing patients. Optimal blood glucose control was considered as The hemoglobin A1C less than 7% and three criteria of the American Diabetes Association was used to assess the patient's care status, SPSS version 21software was used to analyze the chi-square and logistic regression tests to determine the relationship between optimal blood glucose control and independent variables. The results: The mean age and duration of the patients were 59.1 and 6.7 years, respectively, and 66% of the participants were female. A total of 10% of patients mentioned the hospitalization history due to illness during a recent year, and 9.7% of participants had at least one of the complications of diabetes. The mean of Hemoglobin A1C was 7.08 ± 1.37, the mean lower lipid (LDL) was 35.8 ± 112.8 and the mean systolic blood pressure in patients was 124 ± 14.7. In terms of optimal glucose control (A1C <7%), 50.6% of patients had favorable conditions for glucose control and in general, 17.1% of participants in this study achieved three criteria of optimal diabetes care (HBA1C <7%, LDL <100mg / dl, BP <140mm / Hg). In multivariate analysis with logistic regression, after adjusting the effect of confounding variables, there was a statistically significant relationship between duration of diabetes, insulin consumption, referral history to private physician of clinic, visit by a clinician and body mass index with optimal blood glucose control. Conclusion: In general, metabolic control in rural diabetic patients covered by Urmia Health Center was satisfactory. This study showed that the regular referral of diabetic patients for testing hemoglobin A1C (at least twice a year) from rural health centers for patients under coverage could be effective in promoting their care.

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