Responding to the challenges of primary diabetes care through the national diabetes education program.

Abstract

In this issue of Diabetes Care , the article by Paddison et al. (1) provides valuable information that furthers our understanding of the primary care patient experience for people with diabetes. Using the English General Practice Patient Survey (GPPS), the authors compare the primary care experience of 85,760 survey responders with self-reported diabetes with 820,818 responders without diabetes across three domains of care delivery: access, continuity, and communication. Individuals with diabetes reported primary care experiences that were as good as or better than people without diabetes across most domains of care. The authors point out that the concept of family practice in England is not dissimilar to that of the patient-centered medical home (PCMH) articulated in the U.S. Primary care practices in both countries identify patient populations and both share some degree of financial risk for keeping their patients healthy. Despite the similarities, several findings do not broadly generalize to the U.S. health care system. Patient satisfaction surveys reflect perceptions as well as the capabilities of a health care delivery system, but the realities faced by U.S. and U.K. patients are different. In the 2014 National Committee for Quality Assurance annual summary of assessments from U.S. health plans, 94.5% of patients reported that their doctors usually or always explained things, listened carefully, showed respect, and spent enough time, and 86.7% of patients reported that access to care was good, comparing favorably with the GPPS results (2). However, only 67.6% of these …