Association between the continuity of consultation for diabetes patients contracted by family doctors and the management of glycosylated hemoglobin
Objective To analyze the association between continuity of consultation and the management of glycosylated hemoglobin(HbA1c)in diabetes patients contracted by family doctors.Methods This study was a cross-sectional study.From May 2022 to October 2022,three community health service centers in the urban area of Beijing were selected by convenient sampling.A total of 360 diabetes patients were selected by simple random sampling from the selected centers.Extraction of data from electronic health records were conducted to collect patient characteristics,information on the continuity evaluation indicators for patient visits(usual provider of care,UPC)in 2021 and information of monitoring and control indicators for HbA1c in 2021.The monitoring and control of HbA1c in patients with different continuity of consultations were compared.Chi-square test and logistic regression analysis were used to determine the association between continuity of consultation and HbA1c management(i.e.,HbA1c monitoring and control).Results Of the 360 patients,167(46.4％)were male;the age was 68.0(60.0,74.0)years and the number of years since diagnosis was 11.0(7.0,17.0)years.One hundred and fifty-nine patients(44.1％)had UPC scores below 30％,101 patients(28.1％)had UPC scores between 30％and 50％,and 100 patients(27.8％)had UPC scores above 50％.The compliance rate for HbA1c monitoring was 66.4％(239/360),and the compliance rate for HbA1c control was 45.8％(165/360).When the UPC score was less than 30％,between 30％-50％,and greater than 50％,the HbA1c monitoring compliance rates were 53.5％(85/159),73.3％(74/101),and 80.0％(80/100),respectively,and the HbA1c control compliance rates were 37.7％(60/159),51.5％(52/101),and 53.0％(53/100),respectively,and the differences were statistically significant(x2=22.36,7.57,P＜0.05).As the UPC score increased,the likelihood of achieving HbA1c monitoring(OR=1.020,95％CI:1.009-1.030,P＜0.001)and control(OR=1.012,95％CI:1.003-1.021,P=0.008)targets increased.Conclusion There is an association between the continuity of consultation and the management of HbA1c.
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