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Association between continuity of primary care and health outcomes among people with type 2 diabetes and/or hypertension at primary care settings in Central Vietnam
Nhon Bui
7
1
Hue University of Medicine and Pharmacy, Hue University, Vietnam; Ghent University, Belgium Family Medicine Center, Hue University of Medicine and Pharmacy, Hue University, Vietnam; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium 06 Ngo Quyen street, Hue city, 49000 Thua Thien Hue province, Vietnam
2
Hue University of Medicine and Pharmacy, Hue University, Vietnam
3
Ghent University, Belgium Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium Campus UZ-Ghent, Entrance 42, 6th Floor, Corneel Heymanslaan 10, 9000 Gent, Belgium Belgium
4
Ghent University, Belgium
5
University of Antwerp, Antwerp, Belgium Department of Primary and Interdisciplinary Care, University of Antwerp, Belgium Universiteitsplein 1, Antwerp, Wilrijk, 2610, Belgium
6
Hue University of Medicine and Pharmacy, Hue University, Vietnam; Antwerp University, Belgium “Family Medicine Center, Hue University of Medicine and Pharmacy, Hue University, Vietnam; 3 Department of Primary and Interdisciplinary Care, University of Antwerp, Belgium” 06 Ngo Quyen street, Hue city, 49000 Thua Thien Hue province, Vietnam
7
Phu Vang District Health Center, Vietnam Phu Vang District Health Center, Vietnam Phu Da commune, Phu Vang district, Thua Thien Hue 49000, Vietnam
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1472
ABSTRACT
Background:
An alarming rise of poor control of non-communicable diseases (NCDs) calls for a comprehensive response of the health systems to strive towards universal health coverage. Better continuity of care (COC) is an important benchmark for high-quality and efficient health systems. This study aimed to explore the COC for type 2 diabetes mellitus (T2DM) and hypertension across primary care and its association with health outcomes and disease control.
Methods:
A total of 602 people with T2DM and/or hypertension managed in primary care were included. The Nijmegen continuity of care questionnaire (NCQ) valued from 1-5 was used to examine the relational continuity and team/cross-boundary continuity across care levels, the Bice - Boxerman continuity of care index (COCI) valued between 0-1 was used to measure the dispersion of health visits to different providers. Multivariate logistic regression analysis was performed to examine the predictors of COC.
Results:
Mean values of COC indices were COCI 0.77 and NCQ 3.59. The NCQ showed higher relational continuity and team/cross-boundary continuity within primary care compared to specialist care. People with T2DM were more likely to have higher COC regarding specialist care than hypertension and both diseases. Gender, living areas, usual health facility, hospital and emergency department admission, frequency of health visits, disease duration, blood pressure and blood glucose levels, and disease control were demonstrated to be statistically associated with COC.
Conclusions:
COC of Vietnam primary care is not sufficiently achieved for hypertension and diabetes. Strengthening robust primary care services is an essential strategy for chronic care. Our findings reflect that as a multi-dimensional construct, COC is needed to be measured using a robust and integrated assessment approach. More efforts are necessary to geographically align the imbalance of care delivery and increase the efficiency of virtual chronic services, and multidisciplinary and coordinated care for NCDs in primary care.
An alarming rise of poor control of non-communicable diseases (NCDs) calls for a comprehensive response of the health systems to strive towards universal health coverage. Better continuity of care (COC) is an important benchmark for high-quality and efficient health systems. This study aimed to explore the COC for type 2 diabetes mellitus (T2DM) and hypertension across primary care and its association with health outcomes and disease control.
Methods:
A total of 602 people with T2DM and/or hypertension managed in primary care were included. The Nijmegen continuity of care questionnaire (NCQ) valued from 1-5 was used to examine the relational continuity and team/cross-boundary continuity across care levels, the Bice - Boxerman continuity of care index (COCI) valued between 0-1 was used to measure the dispersion of health visits to different providers. Multivariate logistic regression analysis was performed to examine the predictors of COC.
Results:
Mean values of COC indices were COCI 0.77 and NCQ 3.59. The NCQ showed higher relational continuity and team/cross-boundary continuity within primary care compared to specialist care. People with T2DM were more likely to have higher COC regarding specialist care than hypertension and both diseases. Gender, living areas, usual health facility, hospital and emergency department admission, frequency of health visits, disease duration, blood pressure and blood glucose levels, and disease control were demonstrated to be statistically associated with COC.
Conclusions:
COC of Vietnam primary care is not sufficiently achieved for hypertension and diabetes. Strengthening robust primary care services is an essential strategy for chronic care. Our findings reflect that as a multi-dimensional construct, COC is needed to be measured using a robust and integrated assessment approach. More efforts are necessary to geographically align the imbalance of care delivery and increase the efficiency of virtual chronic services, and multidisciplinary and coordinated care for NCDs in primary care.
CITATIONS (1):
1.
Calibrating care: Family caregiving and the social weight of sympathy (tình cảm) in Vietnam
Tine M. Gammeltoft
American Anthropologist
Tine M. Gammeltoft
American Anthropologist
| ISSN: | 2654-1459 |
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