Zhongguo quanke yixue (Dec 2023)
Relationship between Community Health Service Experience and Glycemic Control Outcomes in Patients with Diabetes Mellitus
Abstract
Background Community health services play an effective role in delaying the progression of diabetes and managing diabetes complications. Previous studies have suggested that the subjective experiences of visits to community health centers by patients with diabetes contributes to their improved health outcomes. However, few studies have evaluated the correlation of glycemic control outcomes with specific service processes and objective experiences of programs received by diabetic patients in the community health service centers. Objective To explore the correlation between the community health service experiences and glycemic control outcomes in patients with diabetes mellitus. Methods A cross-sectional survey design and multi-stage, cluster random sampling method was used to select six community health service centers in the central urban area of Guangzhou, with one family doctor team randomly selected from each center. A total of 336 patients with diabetes who visited the corresponding family doctor teams from September to November 2019 were recruited as the study subjects. A questionnaire was conducted to collect baseline information, fasting plasma glucose (FPG) level, and Primary Care Assessment Tool (PCAT) scores. The glycemic control outcomes of patients were assessed based on the FPG level, and their experiences of community health services were assessed based on the PCAT scores. Logistic regression models were used to evaluate the effect of community health service experiences on glycemic control outcomes in diabetic patients. Results The glycemic control rate of the included diabetic patients was 73.2% (246/336). The total PCAT score and the scores for each dimension of PCAT with good glycemic control outcomes were higher than those of patients with poor glycemic control outcomes, and the difference was statistically significant (P<0.05). The results of multivariate Logistic regression showed an effect of total PCAT score on glycemic control outcomes in diabetic patients〔OR (95%CI) =0.12 (0.06, 0.23) 〕, as well as the scores for each dimension of PCAT (P<0.05). The results of subgroup analysis showed that for diabetic patients with different genders, types of health insurance and hypertension history, the total score of PCAT had an effect on the glycemic control outcomes (P<0.05) . Conclusion Community health service experience is a protective factor for the glycemic control outcomes of diabetic patients. Enhancing community health service experience is of great significance for improving the glycemic control outcomes in patients with diabetes.
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