Linking quality of healthcare and health-related quality of life of patients with type 2 diabetes: an evaluative study in Mexican family practice

Abstract

Objective: To assess the association between quality of care and health-related quality of life among type 2 diabetes patients.

Design: A cross-sectional study assessing the association between quality of care and quality of life using multiple linear regression analysis.

Setting: Family medicine clinics (FMC) (n = 39) of the Mexican Institute of Social Security (IMSS) in Mexico City.

Participants: Type 2 diabetes patients (n = 312), older than 19 years.

Main outcome measure(s): Health-related quality of life was measured using the MOS Short-Form-12 (SF-12); quality of healthcare was measured as the percentage of recommended care received under each of four domains: early detection of diabetes complications, non-pharmacological treatment, pharmacological treatment and health outcomes.

Results: The average quality of life score was 41.4 points on the physical component and 47.9 points on the mental component. Assessment of the quality of care revealed deficiencies. The average percentages of recommended care received were 21.9 for health outcomes and 56.6 for early detection of diabetes complications and pharmacological treatment; for every 10 percent additional points on the pharmacological treatment component, quality of life improved by 0.4 points on the physical component (coefficient 0.04, 95% confidence intervals 0.01-0.07).

Conclusions: There was a positive association between the quality of pharmacological care and the physical component of quality of life. The quality of healthcare for type 2 diabetes patients in FMC of the IMSS in Mexico City is not optimal.

Keywords: patient outcomes (health status, quality of life, mortality); quality indicators; quality measurement, quality management.