Quality of life and effectiveness of diabetes care in three different settings in Leuven.
BACKGROUND
The new diabetes protocol, formulated in Belgium as a consensus between the National Institution of Health Insurance and diabetologists, implicitly assumes the care of type 1 diabetic patients to be more efficient at the specialist level (SP) in hospital, although GPs frequently are involved in diabetes care.


OBJECTIVE
A study was carried out in order to highlight differences in diabetes care between three different treatment settings (SP alone, combined SP-GP and GP alone)


METHODS
Out of a group of known diabetics, 325 patients were selected according to a stratified cluster sampling technique, in such a way that the three types of diabetes (formerly called type 1, type 2a and type 2b) occurred sufficiently in the three above-defined treatment settings. Outcome data on co-morbidity and diabetes health profile as well as output data on laboratory results were collected for each patient and compared between the different subgroups.


RESULTS
On the basis of a response rate of 47.9%, equally distributed over the different levels, we demonstrated that GPs and SPs score equally low on the different measures and that a better follow-up is indicated in all settings.


CONCLUSIONS
Diabetes care in Flanders can be upgraded significantly. There is no evidence that specialists are performing better. Therefore, one could argue for better follow-up of diabetes care in a primary health care setting.
Van Loon
H
H
Department of General Practice, KULeuven, Kapucijnenvoer 33 and Medisch Centrum voor Huisartsen, Leuven, Belgium.
Deturck
L
L
Buntinx
F
F
Heyrman
J
J
Degroote
L
L
De Koker
K
K
Vliers
J
J
D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001530:Belgium; D002648:Child; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology* / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology* / Q000628:therapy*; D005194:Family Practice / Q000592:standards*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006801:Humans; D008297:Male; D008511:Medicine / Q000592:standards*; D008875:Middle Aged; D010348:Patient Care Team / Q000592:standards; D011788:Quality of Life; D013038:Specialization; D016896:Treatment Outcome
D006442:Glycated Hemoglobin