Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Ghana.
Department of Biostatistics, School of Public Health, University of Ghana, Legon, Ghana.
Front Public Health. 2023 May 9;11:1141080. doi: 10.3389/fpubh.2023.1141080. eCollection 2023.
Diabetes mellitus is a fast-rising non-contagious disease of global importance that remains a leading cause of indisposition and death. Evidence shows that effective management of diabetes has a close link with continuity of care which is known to be the integral pillar of quality care. This study, therefore, sought to determine the extent of continuity of care between diabetic patients and their care providers as well as factors associated with relational continuity of care.
This cross-sectional, facility-based study was conducted among diabetics in Accra, Ghana. We sampled 401 diabetic patients from three diabetic clinics in the region using a stratified and systematic random sampling technique. Data were collected using a structured questionnaire containing information on socio-demographic characteristics, the four dimensions of continuity of care, and patients' satisfaction. A 5-point Likert scale was used to measure patient's perception of relational, flexible, and team continuity, while most frequent provider continuity was used to measure longitudinal continuity of care. Scores were added for each person and divided by the highest possible score for each domain to estimate the continuity of care index. Data were collected and exported to Stata 15 for analysis.
The results show that team continuity was the highest (0.9), followed by relational and flexibility continuity of care (0.8), and longitudinal continuity of care was the least (0.5). Majority of patients experienced high team (97.3%), relational (68.1%), and flexible (65.3%) continuity of care. Most patients (98.3%) were satisfied with the diabetes care they received from healthcare providers. Female subjects had higher odds of experiencing relational continuity of care as compared to male subjects. Furthermore, participants with higher educational levels were five times more likely to experience relational continuity of care than those with lower educational background.
The study demonstrated that the majority of diabetics had team continuity of care being the highest experienced among the four domains, followed by flexible and longitudinal being the least experienced. Notably, team and flexible continuity of care had a positive association with relational continuity of care. Higher educational level and being female were associated with relational continuity of care. There is therefore the need for policy action on the adoption of multidisciplinary team-based care.
糖尿病是一种快速上升的非传染性疾病，具有全球性重要意义，仍是导致不适和死亡的主要原因。有证据表明，糖尿病的有效管理与连续性护理密切相关，而连续性护理是优质护理的重要支柱。因此，本研究旨在确定糖尿病患者与其护理提供者之间的连续性护理程度，以及与关系连续性护理相关的因素。
这是一项在加纳阿克拉进行的基于医疗机构的横断面研究。我们使用分层和系统随机抽样技术，从该地区的三个糖尿病诊所中抽取了 401 名糖尿病患者。我们使用包含社会人口特征、连续性护理的四个维度以及患者满意度的结构化问卷收集数据。使用 5 点李克特量表来衡量患者对关系、灵活和团队连续性的感知，而最常见的提供者连续性则用于衡量纵向连续性护理。为每个人的每个领域的得分相加，并除以每个领域的最高可能得分，以估计连续性护理指数。数据收集并导出到 Stata 15 进行分析。
结果显示，团队连续性得分最高（0.9），其次是关系和灵活性连续性护理（0.8），而纵向连续性护理得分最低（0.5）。大多数患者经历了较高的团队（97.3%）、关系（68.1%）和灵活（65.3%）连续性护理。大多数患者（98.3%）对他们从医疗保健提供者那里获得的糖尿病护理感到满意。与男性相比，女性患者更有可能经历关系连续性护理。此外，与教育程度较低的患者相比，具有较高教育程度的患者经历关系连续性护理的可能性高五倍。
该研究表明，大多数糖尿病患者具有团队连续性护理，这是四个领域中经历最多的，其次是灵活性和纵向连续性护理，这是经历最少的。值得注意的是，团队和灵活性连续性护理与关系连续性护理呈正相关。较高的教育水平和女性与关系连续性护理相关。因此，需要采取政策行动，采用多学科团队为基础的护理模式。
