title: Results of specialized ambulatory diabetes care among diabetes patients at the level of primary health care--in the light of nationwide research.
abstract: BACKGROUND
  The availability of health services, understood as the ease of access to a given service or help, is a basic element of the operation of the health care system. In the case of people suffering from diabetes, availability of medical services, alongside the duration of the disease and social-economic status, has been deemed as a factor which determines the risk of diabetes-related complications. Research shows that specialized care may delay the development of diabetes complications, therefore it has been assumed that this care should be available to all patients. Combined diabetes patient care management, based on cooperation between general practitioners and specialists, is regarded as an effective way of improving the care of this group of patients.
  
  
  OBJECTIVE
  The paper presents the results of specialized ambulatory care among diabetes patients.
  
  
  METHODS
  Research materials were obtained from 1366 families and 1986 patients with diabetes, aged above 16 years, within the scope of NCSR grant no. 6P05D02320. Tests included directed interviews, assessment of relative fitness and independence of patients, anonymous questionnaires conducted among patients and their families and medical data analysis. The frequency analysis was carried out using the chi-square test of independence.
  
  
  RESULTS
  The research has shown that specialized care provided by diabetes health care centers is not used by more than half of people suffering from diabetes (60.3%). People who state that they use the care provided by doctors in diabetes health care centers in the majority of cases follow most of the recommendations related to nutrition (p = 0.00000) and foot care (p = 0.00698), however they more frequently smoke (p = 0.04209). The findings among the patients who use specialist care most often included complete physical efficiency (p = 0.01821) and self-sufficiency (p = 0.00001), no requirements for treatment of additional diseases (p = 0.00551), normal body weight (p = 0.00655), and blood pressure (p = 0.00589) and lack of knowledge of health indicators essential in diabetes treatment (p = 0.00004). People using the care provided by doctors in diabetes health care centers more often function in a better social situation and living conditions (p = 0.01859) and do not have any difficulty accessing medical services (p = 0.00000). CONCLUSIONS; The research showed positive results among patients using specialized care within the scope of blood pressure, body weight, better foot care, compliance with nutrition recommendations and a lower demand for professional care.
authors.affiliation: Department of Nursing in Primary Health Care, Wroclaw Medical University, Poland. wesola2000@2com.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Abramczyk
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D016009:Chi-Square Distribution; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D048909:Diabetes Complications / Q000175:diagnosis / Q000628:therapy*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000628:therapy*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration; D011044:Poland; D011320:Primary Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires