Research Article: Relationships between the Structural Characteristics of General Medical Practices and the Socioeconomic Status of Patients with Diabetes-Related Performance Indicators in Primary Care
Abstract:
The implementation of monitoring for general medical practice (GMP) can contribute to improving the quality of diabetes mellitus (DM) care. Our study aimed to describe the associations of DM care performance indicators with the structural characteristics of GMPs and the socioeconomic status (SES) of patients. Using data from 2018 covering the whole country, GMP-specific indicators standardized by patient age, sex, and eligibility for exemption certificates were computed for adults. Linear regression models were applied to evaluate the relationships between GMP-specific parameters (list size, residence type, geographical location, general practitioner (GP) vacancy and their age) and patient SES (education, employment, proportion of Roma adults, housing density) and DM care indicators. Patients received 58.64% of the required medical interventions. A lower level of education (hemoglobin A1c test: ? = ?0.108; ophthalmic examination: ? = ?0.100; serum creatinine test: ? = ?0.103; and serum lipid status test: ? = ?0.108) and large GMP size (hemoglobin A1c test: ? = ?0.068; ophthalmological examination ? = ?0.031; serum creatinine measurement ? = ?0.053; influenza immunization ? = ?0.040; and serum lipid status test ? = ?0.068) were associated with poor indicators. A GP age older than 65 years was associated with lower indicators (hemoglobin A1c test: ? = ?0.082; serum creatinine measurement: ? = ?0.086; serum lipid status test: ? = ?0.082; and influenza immunization: ? = ?0.032). Overall, the GMP-level DM care indicators were significantly influenced by GMP characteristics and patient SES. Therefore, proper diabetes care monitoring for the personal achievements of GPs should involve the application of adjusted performance indicators.
Introduction:
According to the International Diabetes Federation, 537 million people were diagnosed with diabetes mellitus (DM) worldwide in 2021, and this figure is expected to increase to 643 million by 2030 [1]. DM affected 9.1% of Hungary’s population in 2021, representing 661,400 people suffering from this disease [1]. DM can effectuate micro- and macrovascular complications, such as late-stage renal failure, blindness, neuropathy, lower-limb amputation, stroke, and myocardial infarction [2], imposing enormous social and…
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