Audit of Diabetes Care at Al Wakra Health Center, Qatar
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- Category: Vol. 77, June 2009
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Audit of Diabetes Care at Al Wakra Health Center, Qatar,NAZAR RAWHYA, AL ANSARI YOUSSEF, MOHAMAD SALEM and ABDULMAJEED AHMAD
Abstract
Introduction: Diabetes is a chronic illness that requires continuing medical care. Patient health education and self management aim to, prevent acute complications and to reduce the risk of long term complications. Diabetic care is a complex proces and requires many issues beyond glycemic control. This study was conducted to assess quality of diabetic care in the diabetic clinic at Al Wakra Health Center and to deter-mine some factors that may affect quality of this care.
Methodology: It is a descriptive cross-sectional study. The target population was all diabetic patients (Type 2) meet the inclusion criteria and registered in the center. The structure of diabetic care was assessed by two checklists, the first checklist is for the essential items of care (thirteen items) and the second one is for the less essential items (ten items). The indicators of the process of diabetic care was assessed by a scoring system depends on ten items for standard diabetic care by the primary care physicians in the past year. Assessment of outcome was undertaken according to an international quality assurance protocol and includes: The degree of diabetic control, obesity, smoking among the diabetic patients and control of blood pressure. We added HbA1c to this list. Another questionnaire was designed to determine factors that may affect quality of care and related to patients knowledge and attitudes and divided into 4 sections, personal data, patient knowledge about diabetes and patient attitude toward care and clinical and biochemical assessments. A pilot study was carried out to test the questionnaires. Epi-info. 6 statistical Package was used for data entry and statistical analysis. Chi square or Fisher exact tests were used to test the significance and p value <0.05 was considered significant.
Results: The study showed that diabetic care in PHC represented by Al Wakra PHC center is better than that care in other studies in different countries. 86.7% of physicians show that most of the structure items are good to fair except absence of chiropodist and identification cards for diabetic patients. Assessment of the process of care showed that there is good to fair recording in 91.75% of cases, foot examination is not recorded in most of cases, funds examination is not recorded in 31.7%. The outcome indicators showed that patient knowledge about diabetes is poor in 35% of cases, uncontrolled FBS in 75.6% of cases, uncontrolled HbA1c in 57.8%, obesity in 63.5% and control of blood pressure is not achieved in 49% of cases.
Conclusion: Diabetic clinic in Al Wakra PHC center provides good care for diabetic patient in term of structure, process and outcome; however, we need more to do for refining these services.