A three-year evaluation of the quality of diabetes care in the Norwich community care scheme.
The care of patients with diabetes was assessed in eight general practices intending to establish mini-clinics. Seven of these practices subsequently participated in a mini-clinic scheme incorporating continuing education and audit. After 3 years further data were collected and compared with the baseline assessment. Seven other local practices which had not set up mini-clinics were also studied. During the time between the baseline survey and the 3-year assessment the proportion of non-insulin-treated patients registered with the mini-clinic practices and receiving regular review in general practice increased from 54 to 84%. The proportions of patients with a record of body weight, blood pressure, urinary glucose, urinary protein, blood glucose, HbA1, visual acuity, examination of the fundus through dilated pupils, examination of the feet, and a consultation with a dietitian within the previous year increased significantly and were higher in mini-clinic than in comparison practices although, for a substantial number of patients in both groups of practices, these remained unrecorded. This study shows that organized and audited general practice mini-clinics can improve the process of care for diabetic patients.
Williams
D R
DR
University Department of Community Medicine, Addenbrooke's Hospital, Cambridge, UK.
Munroe
C
C
Hospedales
C J
CJ
Greenwood
R H
RH
D000328:Adult; D003153:Community Health Services / Q000592:standards*; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy; D004739:England; D006801:Humans; D011787:Quality of Health Care