Quality of Diabetic Care among Patients in a Tertiary Care Hospital in Bangalore, South India: A Cross-sectional Study.

Abstract

Despite high prevalence of diabetes, translation of practice recommendations to care is still deficient in Asian and developed countries. The objective of this study is to assess the quality of care provided to diabetic patients and extent of knowledge transfer by the provider to these patients as a measure of the quality of service. A cross sectional study was done among 190 diabetic patients over a period of 6 months. All type II diabetic patients, 30 years and above, who were diagnosed at least 1 year back without any other co-morbidity satisfied the inclusion criteria. They were interviewed based on an audit checklist formulated by National Diabetes Quality Improvement Alliance. The results revealed that blood pressure is the only parameter which is regularly monitored in majority (93%) of the diabetics. Hb1AC, LDL cholesterol and eye check up were less common and done only in 40%, 52.6% and 56.8% of diabetics respectively. Only 33(17.37%) had at least 5 of the 7 essential parameters monitored at least once in the last year. The knowledge questionnaire showed that more than 70% of the diabetic patients know that their condition requires lifelong management, diet modifications and exercises. There was no difference in the knowledge scores between the people who had no essential tests done and those diabetics who got 5 essential tests done. Gender, education, occupation and duration of diabetes were associated with knowledge score. There is a need to formulate the local standards of care and clinical practice guidelines for the management of diabetes that are easily affordable and available to the health care providers and applicable to our country at the national level. Continuing audit of patients with diabetes is a feasible and a very useful method of promoting and helping to achieve the management goals of a good quality care.