Rebecka Husdal1, Andreas Rosenblad2, Janeth Leksell3, Björn Eliasson4, Stefan Jansson5, Lars Jerdén6, Jan Stålhammar7, Lars Steen8, Thorne Wallman9, Ann-Marie Svensson10, Eva Thors Adolfsson2. 1. Centre for Clinical Research Västmanland, Uppsala University, Västerås, Sweden; Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden. Electronic address: rebecka.husdal@regionvastmanland.se. 2. Centre for Clinical Research Västmanland, Uppsala University, Västerås, Sweden. 3. Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden. 4. Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. 5. School of Medical Sciences, University Health Care Research Centre, Örebro University, Örebro, Sweden. 6. School of Education, Health and Social Studies, Dalarna University, Falun, Sweden; Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden. 7. Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Uppsala, Sweden. 8. Drug and Therapeutics Committee, Sörmland County Council, Eskilstuna, Sweden. 9. Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Uppsala, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden. 10. National Diabetes Register, Centre of Registers, Gothenburg, Sweden.
Abstract
AIMS: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM). METHODS: People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models. RESULTS: After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (-0.02mmol/mol for each additional credit; P<0.001) and length of regular visits to RNs (-0.19mmol/mol for each additional 15min; P<0.001). Organisational features associated with HbA1c level were having a diabetes team (-0.18mmol/mol; P<0.01) and providing group education (-0.20mmol/mol; P<0.01). CONCLUSIONS: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM.
AIMS: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM). METHODS:People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models. RESULTS: After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (-0.02mmol/mol for each additional credit; P<0.001) and length of regular visits to RNs (-0.19mmol/mol for each additional 15min; P<0.001). Organisational features associated with HbA1c level were having a diabetes team (-0.18mmol/mol; P<0.01) and providing group education (-0.20mmol/mol; P<0.01). CONCLUSIONS: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM.
Authors: Sofia Axia Karlsson; Björn Eliasson; Stefan Franzén; Mervete Miftaraj; Ann-Marie Svensson; Karolina Andersson Sundell Journal: BMJ Open Diabetes Res Care Date: 2019-04-08
Authors: Sofia Axia Karlsson; Stefan Franzén; Ann-Marie Svensson; Mervete Miftaraj; Björn Eliasson; Karolina Andersson Sundell Journal: BMC Health Serv Res Date: 2018-11-28 Impact factor: 2.655