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Associations between quality of work features in primary health care and glycaemic control in people with Type 2 diabetes mellitus: a nationwide survey
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.ORCID iD: 0000-0001-8682-2045
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Number of Authors: 112018 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: To describe and analyse the associations between primary health care centres' (PHCCs') quality of work (QOW) and individual HbA1c levels in people with Type 2 diabetes mellitus (T2DM).

METHODS: This cross-sectional study invited all 1152 Swedish PHCCs to answer a questionnaire addressing QOW conditions. Clinical, socio-economic and comorbidity data for 230,958 people with T2DM were linked to data on QOW conditions for 846 (73.4%) PHCCs.

RESULTS: Of the participants, 56% had controlled (≤52mmol/mol), 31.9% intermediate (53-69mmol/mol), and 12.1% uncontrolled (≥70mmol/mol) HbA1c. An explanatory factor analysis identified seven QOW features. The features having a call-recall system, having individualized treatment plans, PHCCs' results always on the agenda, and having a follow-up strategy combined with taking responsibility of outcomes/results were associated with lower HbA1c levels in the controlled group (all p<0.05). For people with intermediate or uncontrolled HbA1c, having individualized treatment plans was the only QOW feature that was significantly associated with a lower HbA1c level (p<0.05).

CONCLUSIONS: This nationwide study adds important knowledge regarding associations between QOW in real life clinical practice and HbA1c levels. PHCCs' QOW may mainly only benefit people with controlled HbA1c and more effective QOW strategies are needed to support people with uncontrolled HbA1c.

Place, publisher, year, edition, pages
2018.
Keywords [en]
Diabetes mellitus, National survey, Primary health care, Quality of health care, Type 2
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-29099DOI: 10.1016/j.pcd.2018.11.005PubMedID: 30545793Scopus ID: 2-s2.0-85057982729OAI: oai:DiVA.org:du-29099DiVA, id: diva2:1271182
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2018-12-25Bibliographically approved

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Leksell, Janeth

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