Tabrizi Jafar S
Dept. of Management and Public Health, Faculty of Health and Nutrition, Tabriz Medical Sciences University/Tabriz, Iran.
J Res Health Sci. 2009 Dec 28;9(2):1-9.
The quality of care from the perspective of people with Type 2 diabetes using a new model (CQMH) including three dimensions of quality in health care (Technical, Service and Customer Quality) was assessed.
A cross-sectional survey with a sample of 577 people with Type 2 diabetes was conducted. Measures were self-reported adherence to national guidelines for technical quality, the Netherlands Institute for Health Services Research questionnaire for service quality and the short form of the Patient Activation Measure for Customer Quality.
There was a significant gap in technical quality between what diabetes care the patients reported receiving and what was recommended in the guideline, particularly for management and lifestyle aspects. For service quality, the lowest scores were for choice of care provider and accessibility of care. The mean Customer Quality score was 64.5 (meaning higher score indicating better quality). A positive relationship was demonstrated between higher technical, service and customer quality scores, and better diabetes control status as well as maintaining continuity of care. The average Quality Index was 70.0 of a 0-100 scale.
Customer Quality appears to be a useful third dimension in conceptualising quality in health care, particularly in the context of chronic disease, where good self-management can improve the outcomes of care. A high proportion of Queensland adults with Type 2 diabetes reported receiving suboptimal care in the majority aspects of provided care services as reflected in the overall Quality Index score indicating substantial room for quality improvement.
采用一种新模型（CQMH）评估了2型糖尿病患者视角下的医疗质量，该模型包括医疗保健质量的三个维度（技术、服务和客户质量）。
对577名2型糖尿病患者进行了横断面调查。测量指标包括自我报告的对技术质量国家指南的遵循情况、荷兰卫生服务研究所在服务质量方面的调查问卷以及客户质量方面患者激活量表的简表。
患者报告接受的糖尿病护理与指南中推荐的护理在技术质量方面存在显著差距，尤其是在管理和生活方式方面。在服务质量方面，得分最低的是护理提供者的选择和护理的可及性。客户质量平均得分为64.5（分数越高表明质量越好）。较高的技术、服务和客户质量得分与更好的糖尿病控制状况以及维持护理连续性之间存在正相关关系。质量指数在0至100分的量表上平均为70.0。
客户质量似乎是在概念化医疗保健质量时一个有用的第三维度，特别是在慢性病背景下，良好的自我管理可以改善护理结果。从总体质量指数得分来看，昆士兰成年2型糖尿病患者中有很大比例报告在提供的护理服务的大多数方面接受的护理未达最佳水平，这表明质量改进有很大空间。
