Predictors of Quality of Care Amongst Gestational Diabetic Patients in Community Hospital [16N

Abstract

INTRODUCTION: The objective of our study was to determine factors that affect the quality of care received by a gestational diabetic patient. METHODS: A retrospective cohort study of gestational diabetic patients' who delivered from January 2013 to December 2015. Patients were given quality scores based on predefined quality of care parameters. Patients were then categorized into high quality vs low quality care based on their quality score. Logistics regression analysis was used to determine the relationship between quality of care and variables of interest. RESULTS: Of 514 eligible patients, 468 (91%) had high quality care and 46 (9%) had low quality care. The predictors of High quality of care are: GDMA type: Medication vs Diet Control (OR: -5.74, p = < 0.001); Sex of Infant: Male vs Female (OR:- 0.74, p = 0.352); Age: 20-35 yrs vs less than 19 yrs (OR: 5.2, p= 0.062) and Greater than 35 yrs vs 19 yrs (OR: 5.2, p= 0.071).Gestational age at Diagnosis of GDM: 24 – 30 wks vs less than 24 weeks (OR:0.42, p= 0.16) and greater than 30 wks vs less than 24 wks (OR: 0.17, p = 0.001).Gestational age at initiation of prenatal care: greater than 24 wks vs less than 24 wks (OR: 0.46, p=0.023). CONCLUSION: Patients on medication control, who had an early diagnosis of gestational diabetes and who initiated prenatal care early were more likely to have high quality. Early initiation of prenatal care and prompt diagnosis of GDM is beneficial to improving quality prenatal care.