Medical Audit of the Quality of Diabetes Care: Is Primary Care More Successful Than Hospitals?

Objective: To assess the quality of diabetes care provided to patients attending primary care settings and hospitals in the State of Qatar. Design: Observational cohort study. Setting: The survey was carried out in primary health care centers and hospitals. Subjects and Methods: The study was conducted from January 2010 to August 2010 among diabetic patients attending primary health care centers and hospitals. Among the patients participating, 575 were from hospitals and 1103 from primary health care centers. Face-to-face interviews were conducted using a structured questionnaire including sociodemographic, clinical, and satisfaction score of the patients. Results: The mean age of the primary care diabetic patients was 46.1 ± 15.1 years and 44.5 ± 14.8 years for hospital patients (P = .03). There was a significant difference observed in terms of age group, gender, marital status, occupation, and consanguinity of the diabetic patients in both medical settings (P < .001). Overweight was less prevalent in primary care patients than in hospital diabetes mellitus patients (40.4% vs 46.4%). A significant variation was observed in the mean values of blood glucose (-0.76), HbA1C (-0.78), LDL (-0.01), albumin (-0.37), bilirubin (-0.76), and triglyceride (-0.01) in primary care patients compared to the mean values of the preceding year. Overall, complications were lower in primary care diabetic patients, and patients attending primary care were more satisfied with the diabetes care. Conclusion: The present study revealed that in general, primary health care provided a better quality of care to diabetic patients compared to that of hospitals. Also, primary care patients had a better satisfaction score towards diabetes care.