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Resources and organisation in primary health care are associated with HbA1c level: a nationwide study of 230958 people with Type 2 diabetes mellitus
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 1878-0210, Vol. 12, no 1, p. 23-33Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2018. Vol. 12, no 1, p. 23-33
Keywords [en]
HbA(1c), Organisation, Personnel resources, Primary health care system, Type 2 diabetes mellitus
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-26370DOI: 10.1016/j.pcd.2017.09.003ISI: 000423008800003PubMedID: 28964673OAI: oai:DiVA.org:du-26370DiVA, id: diva2:1146443
Available from: 2017-10-03 Created: 2017-10-03 Last updated: 2018-06-07Bibliographically approved

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Leksell, JanethJerdén, Lars

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