Measuring adherence rate to quality indicators for diabetes care identified by primary health care in Bahrain

OBJECTIVES: To measure the quality of care for patients with diabetes mellitus at the outpatient clinics from 12 general practitioners clinics (GPC) and one diabetes care clinic (DCC).

METHODS: A cross-sectional study was conducted at the Al-Razi Health Center, Manama, Bahrain, and health records from January to December 2012 were reviewed. The study consisted of 120 patients from GPC, and 80 patients from DCC. Information regarding quality indicators on the management of diabetic care was gathered, which consisted of data on the adherence rate for each of the 8 processes and 4 intermediate outcomes indicators, and was then compared to the standard target.

RESULTS: The average rate for the examination of measurement in GPC for diabetic retina was 0%, diabetic foot was 2%, second microalbuminuria retesting was 13%, and glycosylated hemoglobin test order (HbA1c) was 18%, and in the DCC, 87% (diabetic retina), 97% (diabetic foot), 58% (second microalbuminuria retesting), and 79% (HbA1c). The differences were statistically significant between DCC and GPC.

CONCLUSION: This study has found significant differences in the adherence rate of process and clinical outcome indicators across the GPC, an area that requires further improvements. The DCC, however, highly exceeded the target in 7 indicators, while it was relatively far from the target in the other 3 indicators. The study revealed that adherence to process indicators was not associated with good intermediate outcomes.