title: Factors associated with the effectiveness of diabetes care at primary care settings.
abstract: OBJECTIVE
  To assess the effectiveness of diabetes care and the factors associated with the effectiveness at primary care settings.
  
  
  METHODS
  Data were obtained from reviewing of 1,795 medical patient files of patients with type 2-DM treated at forty-eight primary care settings. Information recorded included characteristics, body mass index, co-morbidity, fasting blood glucose (FBG) and HbA1c levels and health personnel mix types (physicians, pharmacists, nurses, health technical officers and community health workers). HbA1c level of diabetes in 542 of 1,795 medical patient files were analyzed. Glycemic controllability of diabetes patients was defined using FBG and HbA1c levels as the effectiveness indicators of diabetes care.
  
  
  RESULTS
  Of 1,795 patients, 40.8% were able to control their FBG levels and 22.7% of the 542 patients who have HbA1c data could control their HbA1c levels. Multivariate analysis confirmed that age and health personnel mix types are significant factors for glycemic controllability as measured by FBG level (p < 0.01). By measuring HbA1c level, age was also significant factor in diabetes care effectiveness (p = 0.012).
  
  
  CONCLUSIONS
  Age was a significant factor in controlling both FBG and HbA1c levels in type 2 diabetes whereas health personnel, physicians and pharmacists, are significant factors in increasing effectiveness of diabetes care. The policy makers should consider distributing these health personnel to primary care settings and this would be a challenge for the policy makers to develop such a strategy and to implement this policy.
authors.affiliation: Department of Public Health Administration, Faculty of Public Health, Mahidol University, Bangkok, Thailand. teesathira@hotmail.com
authors.forename: Teeraporn
authors.initials: T
authors.lastname: Sathira-Angkura
authors.forename: Sukhontha
authors.initials: S
authors.lastname: Kongsin
authors.forename: Bhusita
authors.initials: B
authors.lastname: Intaraprasong
authors.forename: Junya
authors.initials: J
authors.lastname: Pattaraarchachai
authors.forename: Sukhum
authors.initials: S
authors.lastname: Jiamton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010348:Patient Care Team; D011320:Primary Health Care; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin