Quality of medical care for noninsulin-dependent diabetic patients in a community teaching hospital in Taiwan.
To evaluate the quality of diabetes management provided by a community teaching hospital in Taipei County, the medical records of 208 noninsulin-dependent diabetes mellitus (NIDDM) patients who attended the Department of Internal Medicine, Taiwan Provincial Taipei Hospital, from July to December 1994, were selected at random and reviewed. First visit examination results were compared to the practice guidelines established by the Diabetes Association, Taiwan ROC. The frequency of biochemical tests within the last 3 years was traced for 142 NIDDM patients who had been treated regularly in the hospital. Physicians knowledge and attitudes towards diabetes management were assessed by a questionnaire. The results revealed that the practice guidelines were not followed closely by the physicians. Urinalysis, glycosylated hemoglobin A1c and high-density lipoprotein-cholesterol were the items most frequently neglected. Chest x-rays, electrocardiograms, hemograms and serum electrolytes were seldom arranged for patients without specific symptoms. Although not recommended in the guidelines, most of the physicians arranged liver function tests for their patients. Factors such as physicians knowledge and attitudes, medical insurance, high patient loads and educational levels of patients influenced medical behavior in this study. The results of the study showed that the quality of medical care for diabetes mellitus patients in this community hospital should be improved.
Tseng
F Y
FY
Department of Internal Medicine, Taiwan Provincial Taipei Hospital, Taipei, ROC.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D003153:Community Health Services / Q000592:standards*; D003924:Diabetes Mellitus, Type 2; D005260:Female; D006801:Humans; D016014:Linear Models; D008485:Medical Audit; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011817:Rabbits; D013624:Taiwan