Nader F Fatouh1, Moustafa M Nour El-Din. 1. Health Information Unit, Al-Montazah Health District, Alexandria Directorate of Health Affairs, Egyptian Ministry of Health, Egypt. moustafamn@gmail.com.
Abstract
BACKGROUND: The aim of the present study was to evaluate the quality of service provided to type 2 diabetes in family health facilities in one Health District in Alexandria governorate. Also, the study aimed at assessing the difference in the quality of diabetes care between family health units and family health centers. MATERIAL AND METHODS: Records of 384 diabetic patients in 6 family health units and 3 family health centers were reviewed to abstract variables used to compute process and outcome performance measures for diabetes care. RESULTS: The level of performing process of care measures varied between individual measures with microalbuminuria testing done for 1.3% of the sample while smoking cessation counseling was done for all smokers. All measures were performed in family health centers in higher or equal percentage to family health units. Out of 14 cases who performed glycated hemoglobin test, one case from a family health center had value below 7%. The last measured systolic blood pressure was below 140 mm/Hg for 64.6% of all patients while the last measured diastolic blood pressure was less than 90 mm/Hg for 58.1% of all patients. The total cholesterol level was equal or less than 193 mg/dl for 50.5% of tested 194 patients. Outcome measures showed better control of blood pressure and cholesterol level in patients attended family health units than patients attended family health centers. CONCLUSION AND RECOMMENDATIONS: Diabetes care provided by family health facilities in Al-Montazah health district, Alexandria, was not conforming to diabetes practice guidelines for family physicians. Patient's co-payment might play a role in the low performance of expensive diabetes preventive services. It was recommended to adjust fee for diabetes preventive services according to patients' willingness to pay and to conduct further studies to investigate the effect of financing methods on the quality of care provided under the Egyptian Health Sector Reform Program.
BACKGROUND: The aim of the present study was to evaluate the quality of service provided to type 2 diabetes in family health facilities in one Health District in Alexandria governorate. Also, the study aimed at assessing the difference in the quality of diabetes care between family health units and family health centers. MATERIAL AND METHODS: Records of 384 diabeticpatients in 6 family health units and 3 family health centers were reviewed to abstract variables used to compute process and outcome performance measures for diabetes care. RESULTS: The level of performing process of care measures varied between individual measures with microalbuminuria testing done for 1.3% of the sample while smoking cessation counseling was done for all smokers. All measures were performed in family health centers in higher or equal percentage to family health units. Out of 14 cases who performed glycated hemoglobin test, one case from a family health center had value below 7%. The last measured systolic blood pressure was below 140 mm/Hg for 64.6% of all patients while the last measured diastolic blood pressure was less than 90 mm/Hg for 58.1% of all patients. The total cholesterol level was equal or less than 193 mg/dl for 50.5% of tested 194 patients. Outcome measures showed better control of blood pressure and cholesterol level in patients attended family health units than patients attended family health centers. CONCLUSION AND RECOMMENDATIONS: Diabetes care provided by family health facilities in Al-Montazah health district, Alexandria, was not conforming to diabetes practice guidelines for family physicians. Patient's co-payment might play a role in the low performance of expensive diabetes preventive services. It was recommended to adjust fee for diabetes preventive services according to patients' willingness to pay and to conduct further studies to investigate the effect of financing methods on the quality of care provided under the Egyptian Health Sector Reform Program.
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