Need and disparities in primary care management of patients with diabetes

Gianfranco Damiani, Modesta Visca, Bruno Federico, Salvatore Brugaletta, Maria Donata Bellentani, Alessandra Buja, Rosa Gini, Daniele Donato, Paolo Francesconi, Alessandro Marini, Andrea Donatini, Giorgia Bardelle, Vincenzo Baldo, Mariadonata Bellentani, Antonio Brambilla, Massimiliano Correani, Nunziata Cosentino, Claudio Cricelli, Selene Fulvi, Pietro GallinaGiampiero Mazzaglia, Giuseppe Noto, Federica Palumbo, Alessandro Pasqua, Daniele Romeo, Renato Rubin, Stefano Sforza, Giulia Silvestrini, Eleonora Verdini, Giancarlo Viola

Risultato della ricerca: Contributo in rivistaArticolo in rivista

13 Citazioni (Scopus)

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. 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. 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. 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.
Lingua originaleEnglish
pagine (da-a)56-N/A
RivistaBMC Endocrine Disorders
Volume14
DOI
Stato di pubblicazionePubblicato - 2014

Keywords

  • Health care research
  • Inequalities
  • Prevalence
  • Quality of care

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