Diabetic patient’s treatment at Nonghong hospital health service network Buriram 2016

Abstract

Background: Diabetes Mellitus (DM) is characterized by abnormality of insulin secretion from pancreas which affect to blood sugar level. Higher trend of DM incidence consequently resulted in various public health problems including uncontrolled blood sugar level with other complications. Nonghong public health network provided health care for DM patient according to standard guideline of public health security office for three years since 2013. Researcher as a physician and team manager working in Nonghong public health service network therefore is interested to study outcome of DM management and self-care behavior of DM patient for further strategic planning and outcome improve­ment in Nonghong public health service network
Objective: To evaluate clinical outcome and self-care behavior of diabetic patients in Nonghong community hospital and compare to those of primary care unit (PCU) in Nonghong District.
Setting: Diabetic clinic in Nonghong community hospital and primary care units in Nonghong district of Burirum province.
Methods: A descriptive study collected data from community hospital and PCU from October 1st 2015 to September 30th 2016. There were 1,799 diabetic patients available from electronic database. Self-care behavior of 350 diabetic patients was observed and compared data between groups of patients by unpaired t-test for numerical data. Descriptive statistics were presented with frequency, percentage, mean and standard deviation. Comparative analysis of independent t-test and chi-square test were performed.
Result: Majority of DM patients were women aged between 61-70 years and diagnosed with type II DM for over than 10 years (45.4%), Normal BMI was presented in 49.0% of patients. There were 73.0% and 74.2% of patients had SBP < 140 mmHg and DBP<90 mmHg respectively. Glycemic control of patients found that 74.2% had FBS  180 mg/dl and 37.5% had HbAlc  8. Lipid profile resulted about 67.3% of patients had cholesterol<200 mg/dl, 56.5% had LDL 100 mg/dl, 63.8% had triglyceride between 150-499 mg/dl.Additionally majority of DM patients (53.0%) had self-care behavior at medium level in both Nonghong hospital and Nonghong PCUs. The result revealed that clinical outcome of DM clinic management in Nonghong hospitals compared with those of Nonghong PCUs was different in prevalence of eye, foot and renal complications while cardiovascular complications was similar in both groups.
Conclusion: Clinical outcome of DM management in Nonghong hospitals compared with those of Nonghong primary care units resulted in different prevalence of eye, foot and renal complications. However, there was no difference in cardiovascular complication. Therefore, further operational review will beneficial for strategic planning and organizational DM management system improve­ment through enhancing capacity of PCU in network.