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Evaluation of a diabetes management program in China demonstrated association of improved continuity of care with clinical outcomes

Wei X, Barnsley J, Zakus D, Cockerill R, Glazier R, Su X. Evaluation of a diabetes management program in China demonstrated association of improved continuity of care with clinical outcomes. J Clin Epidemiol.  2008; 61 (9): 932-939.

The aim of the study was to evaluate a community-based diabetes management program in Shanghai, China and to examine the association between continuity of care and clinical outcomes.

The diabetes management program was implemented in downtown Shanghai.  One hundred fifty-six patients participated in the intervention group and 182 patients were in the control group.  Participants were elders without severe diabetic complications.  Patient weight, body mass index, blood pressures, and fasting blood glucose were collected from outpatient records at baseline and the end of the study in both groups.  Fructosamine level was measured to monitor glycemic control for patients in the intervention group.  Continuity of care was measured based on our broad definition.

Improved patient health outcomes were observed in the diabetes management program: patients in the intervention group significantly reduced their weight, systolic blood pressure, and fasting blood glucose compared with those in the control group (P<0.05).  In hierarchical regression models, continuity of care scales had a significant association with weight loss and fasting blood glucose reduction.

This study suggested that continuity based on broad terms can act as an important management tool to improve the quality of primary care in similar urban settings.


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