Evaluating the quality of care for patients with type 2 diabetes mellitus based on the HbA1c: A national survey in Iran

• Main Authors: Ghobad Moradi, Azad Shokri, Amjad Mohamadi-Bolbanabad, Bushra Zareie, Bakhtiar Piroozi
• Format: Article
• Language: English
• Published: Elsevier 2021-03-01
• Series: Heliyon
• Subjects: Diabetes mellitus type 2; HbA1c; Quality of health care; Iran
• Online Access: http://www.sciencedirect.com/science/article/pii/S2405844021005909

Objective: The present study was conducted to evaluate the quality of care for type2 diabetic patients based on the HbA1c in Iran. Materials and methods: This cross-sectional study was conducted in 2019 among patients with type 2 diabetes in Iran. The data were collected through a three-part questionnaire including demographic information, disease-related records, and HbA1C status of patients. Multiple logistic regression was used to investigate the relationship between the outcome variable (HbA1c status) and the independent variables in Stata 12. Results: The mean HBA1c was 8.01 ± 1.76% among 1,198 diabetic patients, and more than 66% of them had HBA1c above 7%, i.e. they had uncontrolled blood sugar levels. HBA1c has the highest average among people with more than 10 years of diabetes (8.47 ± 1.77%), self-employed people (8.36 ± 1.94%), illiterate people or those with elementary education (8.13 ± 1.76%) and people with poor economic status (8.12 ± 1.79%). Also, in the final model, people with more than 10 years of disease history had the highest prevalence of HBA1C > 7 with a chance ratio of 3.28 (P < 0.001, 95%CI: 2.37–4.53) and followed by illiterate people or those with elementary education with a chance ratio of 1.6 (P = 0.020, 95%CI: 1.08–2.39) compared to those with high school diploma or academic education. Conclusion: The prevalence of adverse HBA1c in 66% of the studied subjects indicates an inappropriate status of diabetes control in Iran. This indicates the poor quality of services provided to the diabetics. This is a warning sign and requires appropriate interventions to improve the quality of services provided to diabetic patients.