Factors Associated with the Effectiveness of Diabetes Care at Primary Care Settings
Teeraporn Sathira-Angkura RN, MA*, Sukhontha Kongsin PhD*, Bhusita Intaraprasong PhD*, Junya Pattaraarchachai ScD (Bios)**, Sukhum Jiamton MD, PhD***
Affiliation : * Department of Public Health Administration, Faculty of Public Health, Mahidol University, Bangkok, Thailand ** Department of Community Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand *** Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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 HbA1c levels and health personnel mix types (physicians, pharmacists, nurses, health technical
officers and community health workers). HbA1c level of diabetes in 542 of 1,795 medical patient files were analyzed. Glycemic
controllability of diabetes patients was defined using FBG and HbA1c 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 HbA1c 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 HbA1c level, age was also significant
factor in diabetes care effectiveness (p = 0.012).
Conclusion : Age was a significant factor in controlling both FBG and HbA1c 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.
Keywords : Factors associated, Effectiveness, Diabetes care, Primary care setting
