J Clin Outcomes Manage
Quality of care for Type 2 diabetes mellitus in a military primary care setting
Guzu AH, Shehri AA, Khashan HIA, Mishriky AM
ABSTRACT Objective: To assess the quality of care provided to patients with type 2 diabetes in a military primary care setting. Design: Cross-sectional records-based study. Methods: The records of 543 adults with type 2 diabetes at the Al Kharj Military Industry Corporation Hospital, Saudi Arabia, were reviewed, and 16 process and 7 outcome quality indicators were assessed. Results: Compliance with process indicators was variable, with more than 90% of the patients having measurement of HbA1c at least twice yearly and serum cholesterol, triglycerides, and creatinine at least once yearly, whereas less than half had LDL and HDL cholesterol, microalbuminuria, albumin-creatinine ratio, and foot examination at least once yearly. None had documented influenza or pneumococcal vaccination. For outcome indicators, 10.4% had glycemic control and 18.7% had controlled hypertension. Only 3 patients (0.6%) had both glycemic and LDL control, 9 patients (1.7%) had controlled glycemia and hypertension, and 1 patient (0.2%) had control of the 3 parameters. The mean level of HbA1c was lowest among patients controlled by diet only (P < 0.001). Conclusion: The findings indicate low compliance with process quality indicators and even worse compliance with outcome indicators, particularly when combined. The wide gap between optimum outcomes and actual practice points to the need for concerted efforts to implement improvement interventions to close the gap.
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