Quality of diabetes care in public primary care clinics in Hong Kong

Abstract

Background: Little is known about the quality of care for patients with Type 2 diabetes in primary care setting in Hong Kong.

Objectives: To investigate the quality of care for patients with Type 2 diabetes in Hong Kong primary care setting and potential disparities by patient characteristics and clinics.

Methods: Cross-sectional study in three general outpatient clinics (GOPCs; public primary care clinics) in Hong Kong involving 1970 patients. Main outcome measures were achievement rates of seven process measures and three intermediate outcome targets and adjusted odds ratios of age, sex, socio-economic status and clinic on the quality measures.

Results: The achievement rates for the recording of HbA1c, blood pressure (BP), cholesterol, body mass index, smoking status, nephropathy screening and retinopathy screening in the previous 12 months were 92.8%, 99.9%, 91.0%, 47.9%, 91.3%, 69.0% and 38.0%, respectively. A total of 58.0%, 38.2% and 36.4% of patients achieved the glycaemic, BP and cholesterol targets, respectively. Older patients were less likely to have records of process measures and more likely to achieve the HbA1c target. Women were less likely to have smoking status recorded and to achieve the HbA1c target. Patients of lower socio-economic status were less likely to have records of process measures and to achieve the BP target. Family medicine training practices had better achievements of the quality measures.

Conclusions: There is scope for improvement in the quality of diabetes care in the GOPCs. Variations in the quality of care were observed. Family medicine training may enhance the health care quality.