Abstract
ObjectivesTo evaluate the relationship between Patient Assessment of Chronic Illness Care in community health centers and self-management behaviors and glycemic control and to examine the relationship between Patient Assessment of Chronic Illness Care in community health centers and the utilization of community health centers for monitoring and treating diabetes among the patients with type 2 diabetes.MethodsA questionnaire including self-management behaviors, glycemic control, Patient Assessment of Chronic Illness Care in community health centers and the most often utilized medical institutions for monitoring and treating diabetes (community health centers vs. hospitals) was administered to 960 patients with type 2 diabetes in Shanghai, China. The relationships between Patient Assessment of Chronic Illness Care and self-management behaviors, self-management behaviors and glycemic control, Patient Assessment of Chronic Illness Care and glycemic control, Patient Assessment of Chronic Illness Care and the most often utilized medical institutions for monitoring and treating diabetes were examined.ResultsWilcoxon rank sum tests showed that the high scores of total Patient Assessment of Chronic Illness Care and five subscales in community health centers were positively related to almost all the proper self-management behaviors and good glycemic control (p<0.05). Almost all of the proper self-management behaviors were positively related to good glycemic control (p<0.01). High summary score of the Patient Assessment of Chronic Illness Care was positively associated with the utilization of community health centers for monitoring and treating diabetes (p<0.001).ConclusionsPatient Assessment of Chronic Illness Care (implementation of the Chronic Care Model) in community health centers was associated with patients' self-management behaviors and glycemic control, and finally was associated with the utilization of community health centers for monitoring and treating diabetes.
Highlights
As the elderly population continues to grow in China, the prevalence of chronic diseases is on the rise
Community health centers were mainly responsible for primary care and preventive health care of chronic diseases, including implementing electronic registry, establishing electronic patient records, providing primary care, conducting health education for patients and following-up patients, which were mainly provided by general practitioners and preventive health experts
Chi-Square tests showed that almost all of the proper self-management behaviors were positively related to good glycemic control among the patients with type 2 diabetes (Table 3)
Summary
As the elderly population continues to grow in China, the prevalence of chronic diseases is on the rise. Chronic diseases continue to be a significant burden on the health care system in China. In China, Shanghai has the heaviest burden of chronic diseases, because it has the largest population and the largest ageing population [1]. Prevention and management of chronic disease is an urgent primary health problem to be addressed in Shanghai. Efforts to improve the quality of chronic disease management in community health centers have been made in Shanghai. Community health centers were mainly responsible for primary care and preventive health care of chronic diseases, including implementing electronic registry, establishing electronic patient records, providing primary care, conducting health education for patients and following-up patients, which were mainly provided by general practitioners and preventive health experts. The overuse of high level hospitals and the underuse of primary care services by patients have been widespread in China [6]
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