The Results of Medical Services for Prevention and Care of Diabetes Mellitus Type 2 Patients at Primary Care Unit under Universal Coverage System

ABSTRACT

OBJECITVE To study the results of medical services for prevention and care of diabetes mellitus type 2 patients at primary care unit.METHOD: A descriptive study was conducted from October to December, 2005. The main components of the study were budget for screening, drugs for diabetes mellitus treatment, processes of medical services for prevention and care such as screenings, treatments, referral, home visits, and health education and the results composed of fasting blood sugar, comorbidities cholesterol, body mass index, blood pressure and behavior of diabetes mellitus patients. The data were gathered from routine reports and questionnaires with twelve providers, and 326 type 2 diabetes patients at primary care unit in 3 contracting units for primary care Watbot, Bangkratum, and Nernmaprang. The subjects were selected by purposive sampling. The data were analyzed by descriptive statistics such as frequency, percentage, average and standard deviation.RESULTS: Expenditure for screening and patient care was 14.4% of the whole budget for prevention and promotion. Drugs such as sulphonylurea and biguanide were inadequate in some primary care units but this problem could be solved. Screening, follow-up, referral, and home visits did not perfectly follow the universal coverage guidelines for diabetes mellitus care. 35.6% patients were well controlled. Only 0.9% of the patients showed appropriate self-care behavior. Diabetes mellitus screening in 66.3% population over 40 years of age was done. However, only 65.9% of the suspected cases were confirmed, that did not meet the criteria.CONCLUSIONS: The medical services for diabetes mellitus prevention and care does not perfectly follow the universal coverage guidelines. It may be due to lack of clarity in resource allocation and standard medical services guidelines for prevention and care of diabetes mellitus.