Type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas

ERWIN DE BLIEKREIN POSTHUMA

SUPERVISOR: M. GLASSER, PHDSCIENTIFIC ELECTIVE

05-26-2008 - 09-26-2008

Type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas

Introduction

Scientific elective Part of our 6th year as medical students 18 weeks Student is able to choose the project Collaboration between University of Maastricht and

UIC:J. Metsemakers and M. Glasser

Context

Diabetes is a serious health care problem 17.9 million diabetes patients Life-long monitoring Considerable costs

American Diabetes Association (ADA) guidelines Focuses mainly on what the physician should do

according to research and the evidence base

Patient’s view receives little attention

Context

Diabetes care is a challenge in rural areas Limited resources Few diabetes programs Lack of accessibility to speciality centers Lack of availability Lack of healthcare providers

Rural diabetes care is suboptimal when compared to more urban areas1

Aim of the study

Assess patients’ perspectives about diabetes care Satisfaction Expectation

Examine attitudes in relation to: gender and educational status

Determine physician perspectives of diabetes care they provide to patients

Understand perceived barriers to diabetes care

Methods

Participants Rural patients with type 2 diabetes Health care providers, family physicians, nurse

practioners4 Health clinics in Northern IllinoisPatients recruited through WHO-codes

Considered to be active if visited clinic in past three yearsExclusion

< 21 years Unable to understand English

Rurality was determined by the Rural Urban Commuting codes (RUCA) RUCA ≥4 is considered as rural

Methods

In total 1078 eligible patients

Questionnaires were mailed to participants with postage paid return envelope

Non-respondents received a reminder after three weeks

Clinic visits to leave surveys at front desk

Methods

Patient Questionnaire:1. General health questions2. Diabetes Treatment

Satisfaction Scale2

3. Diabetes Attitude Scale3

4. HbA1c knowledge5. Check-ups related to

ADA6. Delgado Expectation

Scale7. Barrier list8. Characteristics of

patient

Physician Questionnaire1. Diabetes control of

their patients2. Satisfaction about

given diabetes care3. Check-ups related to

ADA4. Delgado expectation

scale 5. Barrier list

WESP\Questionnaires\Patient Diabetes Survey 20080731.pdf

Discussion

Useful to know patients’ views of their diabetes care Care should also be focused on patients needs and

expectations Diabetes needs an interdisciplinary approach Low response rate (16.6%) to-date?

The elderly patient Indirect approach

References

1. Andrus MR, Kelley KW, Murphey LM, Herndon KC. A comparison of diabetes care in rural and urban medical clinics in Alabama. J Community Health. 2004 Feb;29(1):29-44.

2. Bradley C, Plowright R, Stewart J, Valentine J, Witthaus E. The Diabetes Treatment Satisfaction Questionnaire change version (DTSQc) evaluated in insulin glargine trials shows greater responsiveness to improvements than the original DTSQ. Health Qual Life Outcomes. 2007;5:57.

3. Anderson RM, Fitzgerald JT, Funnell MM, Gruppen LD. The third version of the Diabetes Attitude Scale. Diabetes Care. 1998 Sep;21(9):1403-7.

*Farewell Party*

 Picnic shelter Sinnissippi Park

Thursday, September 18th From 5 pm till 8 pm

Please let us know, if you are able to come([email protected]) Spouses are welcome

We hope to see you!