Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran
Abstract Background Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifyi...
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doaj-965831c46166493fb75a0cd0767804b92021-09-05T11:17:53ZengBMCBMC Health Services Research1472-69632021-08-0121111210.1186/s12913-021-06932-0Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in IranMahdi Mahdavi0Mahboubeh Parsaeian1Shiva Borzouei2Reza Majdzadeh3The Bernard Lown Scholar in Cardiovascular Health, Harvard T.H. Chan School of Public HealthSchool of Public Health, Tehran University of Medical SciencesDepartment of Internal Medicine, School of Medicine, Hamadan University of Medical SciencesSchool of Public Health, Tehran University of Medical SciencesAbstract Background Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience. Methods We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software. Results After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making). Conclusions Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place.https://doi.org/10.1186/s12913-021-06932-0Type 2 diabetesQuality of lifeSatisfaction with healthcareSatisfaction with health statusPatient experienceHealthcare structure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mahdi Mahdavi Mahboubeh Parsaeian Shiva Borzouei Reza Majdzadeh |
spellingShingle |
Mahdi Mahdavi Mahboubeh Parsaeian Shiva Borzouei Reza Majdzadeh Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran BMC Health Services Research Type 2 diabetes Quality of life Satisfaction with healthcare Satisfaction with health status Patient experience Healthcare structure |
author_facet |
Mahdi Mahdavi Mahboubeh Parsaeian Shiva Borzouei Reza Majdzadeh |
author_sort |
Mahdi Mahdavi |
title |
Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran |
title_short |
Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran |
title_full |
Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran |
title_fullStr |
Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran |
title_full_unstemmed |
Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran |
title_sort |
identifying associations between health services operational factors and health experience for patients with type 2 diabetes in iran |
publisher |
BMC |
series |
BMC Health Services Research |
issn |
1472-6963 |
publishDate |
2021-08-01 |
description |
Abstract Background Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience. Methods We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software. Results After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making). Conclusions Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place. |
topic |
Type 2 diabetes Quality of life Satisfaction with healthcare Satisfaction with health status Patient experience Healthcare structure |
url |
https://doi.org/10.1186/s12913-021-06932-0 |
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