Contributions of patient characteristics and organizational factors to patient outcomes of diabetes care in Hualien, Taiwan
Year: 2003
Type: dissertation
Study design: Observational Study
Abstract: This cross-sectional study measured quality of diabetes care and explored the \ncontributions of patient and organizational factors to patient outcomes of diabetes care in \nHualien, Taiwan. Donabedian’s structure-process-outcome framework was applied to \nexamine the system of health care in Hualien County with respect to the quality and \noutcomes related to patients with diabetes. \nOne hundred forty participants were randomly selected from the list of individuals \nwith diabetes who were seen at the medical center in Hualien during 2000 and 2001. Data \ncollection included administering questionnaires through the mail or by direct interview \nin early 2003 and reviewing medical records over the course of the year 2002. \nPatient characteristics (gender, age, education, ethnicity, occupation, length of \ntime since diagnosis, pattern of diabetes treatment, and comorbidity) and organizational \nfactors in terms of structure (institute characteristics and physician specialty) and the care \nprocess (patient-physician relationships, organizational collaboration, and preventive \nmonitoring and diabetes education) were examined in light of their contributions to \npatient outcomes: glycemic control, adherence to self-care regimen, and quality of care . \nFindings included: three patient outcomes of diabetes care, diabetes professional \nperformance, and contributions of patient and organizational factors to the outcomes. The \naverage A1C level was 8.27%; patient adherence to self-care regimen was moderate. \nScores of patient perception of quality of life were lower in physical and psychological \ndomains but higher in social relations and environmental domains than scores in other \nstudies. Data about professional performance showed a need to improve preventive care \nfor patients. \nRegression procedures highlighted the contributions of patient and organizational \nfactors to patient outcomes. The structure of care (institute characteristics, and physician \nspecialty) accounted for 8.1 % of the variation in glycemic control. Patient characteristics \n(level of education and ethnicity) and organizational factors (structure and process, health \ninstitute characteristics and patient-professional relationships) accounted for 23.0% of the \nvariance in adherence to self-care. Patient characteristics (patient ethnicity and \ncomorbidity) and interpersonal processes of care (patient-professional relationships) \naccounted for 31.1% of the variance in perceptions of quality of life.
Author: Shu‐Chuan Chang
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1789567277