Assessment of diabetic care and patients' satisfaction: an exploratory study

Abstract

BackgroundIt is expected that 438 million people will be affected by diabetes mellitus worldwide by 2030. Therefore, assessment of the quality of diabetic care from different dimensions, including patients' perspectives, is necessary. We did an exploratory study at Shouka Health Center, Gaza Strip, occupied Palestinian territory. MethodsWe collected medical records of patients with diabetes from August, 2011, to October, 2011, to assess completeness of diabetic files. We assessed nurses' and doctors' management plans using a modified United Nations Relief and Works Agency (UNRWA) Gaza Field Health Programme Checklist. Each item had three components; we summed scores for each item for the three components to produce an overall scaled index as a percentage for diabetic care. Additionally, we assessed patient satisfaction through exit interviews with five domains addressing health-provider care, health-provider communication, and self-care using a modified version of the Diabetic Continuity of Care Scale (Cronbach's α 0·75). We assessed differences between grouped variables using χ2 and t tests at a significance level of p<0·05. Statistical analysis was done with SPSS software (version 11.5). The study was approved by the ethics committee and written informed consent was obtained. FindingsWe collected 81 records. The overall scale of diabetic care quality was 85·5%. Overall patient satisfaction was 78·1% and satisfaction with doctors' care was 89·6%. Doctors' management plans scored the lowest satisfaction (77·9%) whereas completeness of patient records scored the highest (97·8%). We noted a significant positive correlation between doctors' management plans and overall satisfaction (r=0·24, p=0·03), completeness of files and overall satisfaction (r=0·27, p=0·02), doctors' management plans and access or care domain (r=0·28, p=0·01), and completeness of files and access or care domain (r=0·23, p=0·05). However, there was no significant correlation between the quality of diabetic care index and the overall satisfaction (r=0·16, p=0·19). Factor analysis showed that staff attitude was the most influential factor on overall satisfaction. InterpretationStaffs' attitude and their commitments seem important to patients' overall satisfaction. Training of doctors properly to manage diabetic patients should be intensified. The relationship between overall satisfaction and the diabetic care quality was obscured by self-care and other health professional care dissatisfaction. Limitations of our study include that exit interviews only capture patients who attend, and do not include those who do not attend, which might be affected by quality of the care. FundingNone.