Quality of delivered care for people with type 2 diabetes: a new patient-centred model

ABSTRACT

The quality of care from the perspective of people with type 2 diabetes using a new model [CQMH] including three dimensions of quality in health care [Technical, Service and Customer Quality] was assessed. A cross-sectional survey with a sample of 577 people with type 2 diabetes was conducted. Measures were self-reported adherence to national guidelines for technical quality, the Netherlands Institute for Health Services Research questionnaire for service quality and the short form of the Patient Activation Measure for Customer Quality. There was a significant gap in technical quality between what diabetes care the patients reported receiving and what was recommended in the guideline, particularly for management and lifestyle aspects. For service quality, the lowest scores were for choice of care provider and accessibility of care. The mean Customer Quality score was 64.5 [meaning higher score indicating better quality]. A positive relationship was demonstrated between higher technical, service and customer quality scores, and better diabetes control status as well as maintaining continuity of care. The average Quality Index was 70.0 of a 0-100 scale. Customer Quality appears to be a useful third dimension in conceptualizing quality in health care, particularly in the context of chronic disease, where good self-management can improve the outcomes of care. A high proportion of Queensland adults with type 2 diabetes reported receiving suboptimal care in the majority aspects of provided care services as reflected in the overall Quality Index score indicating substantial room for quality improvement