A survey on the quality of standardized diabetes management in primary care facilities

Background: The rising incidence of diabetes has led China to prioritize the management of type 2 diabetes within community health services. However, there remain gaps in standardized diabetes management in primary care facilities, particularly in terms of quality and capacity. Objective: This study...

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Main Authors: YANG Rong, JIN Hua, SHI Ling, YI Chuntao, HOU Jin, CHEN Chen, HUAN Hongmei, NI Hengru, YU Dehua
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2024-12-01
Series:Chinese General Practice Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950559324000452
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author YANG Rong
JIN Hua
SHI Ling
YI Chuntao
HOU Jin
CHEN Chen
HUAN Hongmei
NI Hengru
YU Dehua
author_facet YANG Rong
JIN Hua
SHI Ling
YI Chuntao
HOU Jin
CHEN Chen
HUAN Hongmei
NI Hengru
YU Dehua
author_sort YANG Rong
collection DOAJ
description Background: The rising incidence of diabetes has led China to prioritize the management of type 2 diabetes within community health services. However, there remain gaps in standardized diabetes management in primary care facilities, particularly in terms of quality and capacity. Objective: This study aims to evaluate the current status of diabetes management and provide a systematic quality assessment. Recommendations for improvement are proposed based on identified issues. Methods: In May 2022, a survey was conducted involving 249 community health centers of Shanghai. A simple random sampling method was used to select 3,875 general practitioners(GPs), representing 50 % of the registered GPs at each center. Data were collected using a self-designed questionnaire. Results: All community health centers of Shanghai were able to conduct HbA1c tests; however, screening for diabetic complications was insufficient, with only 16.9 % offering nerve conduction velocity tests. The availability of oral hypoglycemic agents was relatively comprehensive, but insulin options were limited, with only 7.6 % of centers had novel GLP-1 available. Furthermore, only 57.4 % of centers had diabetes specialty clinics. GPs demonstrated strong adherence to diabetes management guidelines but had significant knowledge gaps in medication use, with correct responses regarding oral hypoglycemic agents at 27.9 % and insulin at 29.0 %. GPs tended to transfer new patients with high blood glucose or confirmed diabetic nephropathy to higher-level hospitals. Conclusion: The infrastructure, equipment, and medications for diabetes management in Shanghai's community health centers partially meet basic quality standards, but there are significant gaps in GPs' knowledge of diabetes medications. To improve diabetes management, efforts should focus on expanding complication screening, increasing the availability of novel hypoglycemic agents and insulin types, enhancing the development of diabetes specialty clinics, and providing GPs with further training to improve their diagnostic and treatment capabilities.
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spelling doaj-art-30cb0a0dbadc44b9a03cf961706b3de32025-08-20T02:06:15ZengKeAi Communications Co., Ltd.Chinese General Practice Journal2950-55932024-12-011410003210.1016/j.cgpj.2024.11.001A survey on the quality of standardized diabetes management in primary care facilitiesYANG Rong0JIN Hua1SHI Ling2YI Chuntao3HOU Jin4CHEN Chen5HUAN Hongmei6NI Hengru7YU Dehua8Department of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, PR China; Shanghai General Practice and Community Health Development Research Center, Shanghai, PR China; Research Center for General Practice, School of Medicine, Tongji University, Shanghai, PR China; Shanghai General Practice Clinical Quality Control Center, Shanghai, PR ChinaDepartment of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, PR China; Shanghai General Practice and Community Health Development Research Center, Shanghai, PR China; Research Center for General Practice, School of Medicine, Tongji University, Shanghai, PR China; Shanghai General Practice Clinical Quality Control Center, Shanghai, PR ChinaShanghai General Practice Clinical Quality Control Center, Shanghai, PR China; Community Health Management Center of Putuo District, Shanghai, PR ChinaShanghai General Practice Clinical Quality Control Center, Shanghai, PR China; Shanghai Xuhui District Health Commission Supervision Institute, Shanghai, PR ChinaShanghai General Practice Clinical Quality Control Center, Shanghai, PR China; Shanghai Pudong New Area Community Health Guidance Center, Shanghai, PR ChinaShanghai General Practice Clinical Quality Control Center, Shanghai, PR China; Shanghai Jing'an District Jiangning Subdistrict Community Health Center, Shanghai 200040, PR ChinaShanghai General Practice Clinical Quality Control Center, Shanghai, PR China; Shanghai Minhang District Gumei Community Health Center, Shanghai, PR ChinaShanghai General Practice Clinical Quality Control Center, Shanghai, PR China; Shanghai Baoshan District Gucun Town Community Health Center, Shanghai, PR ChinaDepartment of General Practice, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, PR China; Shanghai General Practice and Community Health Development Research Center, Shanghai, PR China; Research Center for General Practice, School of Medicine, Tongji University, Shanghai, PR China; Shanghai General Practice Clinical Quality Control Center, Shanghai, PR China; Corresponding author.Background: The rising incidence of diabetes has led China to prioritize the management of type 2 diabetes within community health services. However, there remain gaps in standardized diabetes management in primary care facilities, particularly in terms of quality and capacity. Objective: This study aims to evaluate the current status of diabetes management and provide a systematic quality assessment. Recommendations for improvement are proposed based on identified issues. Methods: In May 2022, a survey was conducted involving 249 community health centers of Shanghai. A simple random sampling method was used to select 3,875 general practitioners(GPs), representing 50 % of the registered GPs at each center. Data were collected using a self-designed questionnaire. Results: All community health centers of Shanghai were able to conduct HbA1c tests; however, screening for diabetic complications was insufficient, with only 16.9 % offering nerve conduction velocity tests. The availability of oral hypoglycemic agents was relatively comprehensive, but insulin options were limited, with only 7.6 % of centers had novel GLP-1 available. Furthermore, only 57.4 % of centers had diabetes specialty clinics. GPs demonstrated strong adherence to diabetes management guidelines but had significant knowledge gaps in medication use, with correct responses regarding oral hypoglycemic agents at 27.9 % and insulin at 29.0 %. GPs tended to transfer new patients with high blood glucose or confirmed diabetic nephropathy to higher-level hospitals. Conclusion: The infrastructure, equipment, and medications for diabetes management in Shanghai's community health centers partially meet basic quality standards, but there are significant gaps in GPs' knowledge of diabetes medications. To improve diabetes management, efforts should focus on expanding complication screening, increasing the availability of novel hypoglycemic agents and insulin types, enhancing the development of diabetes specialty clinics, and providing GPs with further training to improve their diagnostic and treatment capabilities.http://www.sciencedirect.com/science/article/pii/S2950559324000452Community health service centerGeneral practitionersDiabetes mellitusManagement quality
spellingShingle YANG Rong
JIN Hua
SHI Ling
YI Chuntao
HOU Jin
CHEN Chen
HUAN Hongmei
NI Hengru
YU Dehua
A survey on the quality of standardized diabetes management in primary care facilities
Chinese General Practice Journal
Community health service center
General practitioners
Diabetes mellitus
Management quality
title A survey on the quality of standardized diabetes management in primary care facilities
title_full A survey on the quality of standardized diabetes management in primary care facilities
title_fullStr A survey on the quality of standardized diabetes management in primary care facilities
title_full_unstemmed A survey on the quality of standardized diabetes management in primary care facilities
title_short A survey on the quality of standardized diabetes management in primary care facilities
title_sort survey on the quality of standardized diabetes management in primary care facilities
topic Community health service center
General practitioners
Diabetes mellitus
Management quality
url http://www.sciencedirect.com/science/article/pii/S2950559324000452
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