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Need and disparities in primary care management of patients with diabetes.
- Source :
-
BMC endocrine disorders [BMC Endocr Disord] 2014 Jul 10; Vol. 14, pp. 56. Date of Electronic Publication: 2014 Jul 10. - Publication Year :
- 2014
-
Abstract
- Background: An aging population means that chronic illnesses, such as diabetes, are becoming more prevalent and demands for care are rising. Members of primary care teams should organize and coordinate patient care with a view to improving quality of care and impartial adherence to evidence-based practices for all patients. The aims of the present study were: to ascertain the prevalence of diabetes in an Italian population, stratified by age, gender and citizenship; and to identify the rate of compliance with recommended guidelines for monitoring diabetes, to see whether disparities exist in the quality of diabetes patient management.<br />Methods: A population-based analysis was performed on a dataset obtained by processing public health administration databases. The presence of diabetes and compliance with standards of care were estimated using appropriate algorithms. A multilevel logistic regression analysis was applied to assess factors affecting compliance with standards of care.<br />Results: 1,948,622 Italians aged 16+ were included in the study. In this population, 105,987 subjects were identified as having diabetes on January 1st, 2009. The prevalence of diabetes was 5.43% (95% CI 5.33-5.54) overall, 5.87% (95% CI 5.82-5.92) among males, and 5.05% (95% CI 5.00-5.09) among females. HbA1c levels had been tested in 60.50% of our diabetic subjects, LDL cholesterol levels in 57.50%, and creatinine levels in 63.27%, but only 44.19% of the diabetic individuals had undergone a comprehensive assessment during one year of care. Statistical differences in diabetes care management emerged relating to gender, age, diagnostic latency period, comorbidity and citizenship.<br />Conclusions: Process management indicators need to be used not only for the overall assessment of health care processes, but also to monitor disparities in the provision of health care.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Datasets as Topic
Diabetes Mellitus, Type 2 diagnosis
Diabetes Mellitus, Type 2 epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient Compliance
Prognosis
Risk Assessment
Young Adult
Diabetes Mellitus, Type 2 therapy
Disease Management
Health Services Needs and Demand
Healthcare Disparities standards
Primary Health Care standards
Quality Indicators, Health Care standards
Subjects
Details
- Language :
- English
- ISSN :
- 1472-6823
- Volume :
- 14
- Database :
- MEDLINE
- Journal :
- BMC endocrine disorders
- Publication Type :
- Academic Journal
- Accession number :
- 25011729
- Full Text :
- https://doi.org/10.1186/1472-6823-14-56