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Resources and organisation in primary health care are associated with HbA(1c) level: A nationwide study of 230 958 people with Type 2 diabetes mellitus
Centre for Clinical Research Västmanland, Uppsala University, Västerås, Sweden; Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden.
Centre for Clinical Research Västmanland, Uppsala University, Västerås, Sweden.
Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden.
Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
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2018 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 12, no 1, p. 23-33Article in journal (Refereed) Published
Abstract [en]

Aims: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbAic level in people with Type 2 diabetes mellitus (T2DM).

Methods: People with T2DM attending 846 PHCCs (n =230 958) were included in this crosssectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models.

Results: After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbAi, level were mean credits of diabetes specific education among registered nurses (RNs) (-0.02 mmol/mol for each additional credit; P < 0.001) and length of regular visits to RNs (-0.19 mmol/mol for each additional 15 min; P < 0.001). Organisational features associated with HbAie level were having a diabetes team (-0.18 mmol/mol; P <0.01) and providing group education (-0.20 mmol/mol; P < 0.01).

Conclusions: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA(1c), level in people with T2DM.

Place, publisher, year, edition, pages
Elsevier, 2018. Vol. 12, no 1, p. 23-33
Keywords [en]
HbA(1c), Organisation, Personnel resources, Primary health care system, Type 2 diabetes mellitus
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-64822DOI: 10.1016/j.pcd.2017.09.003ISI: 000423008800003PubMedID: 28964673Scopus ID: 2-s2.0-85030148709OAI: oai:DiVA.org:oru-64822DiVA, id: diva2:1180604
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council  

Region Västmanland 

Available from: 2018-02-06 Created: 2018-02-06 Last updated: 2018-02-06Bibliographically approved

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Jansson, Stefan P. O.

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