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Type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas

Type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas. ERWIN DE BLIEK REIN POSTHUMA SUPERVISOR: M. GLASSER, PHD SCIENTIFIC ELECTIVE 05-26-2008 - 09-26-2008. Introduction. Scientific elective Part of our 6th year as medical students 18 weeks

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Type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas

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  1. Type 2 diabetes patients’ perceptions of and satisfaction with healthcare in rural areas ERWIN DE BLIEK REIN POSTHUMA SUPERVISOR: M. GLASSER, PHD SCIENTIFIC ELECTIVE 05-26-2008 - 09-26-2008

  2. Introduction • Scientific elective • Part of our 6th year as medical students • 18 weeks • Student is able to choose the project • Collaboration between University of Maastricht and UIC:J. Metsemakers and M. Glasser

  3. Context • Diabetes is a serious health care problem • 17.9 million diabetes patients • Life-long monitoring • Considerable costs • American Diabetes Association (ADA) guidelines • Focuses mainly on what the physician should do according to research and the evidence base • Patient’s view receives little attention

  4. Context • Diabetes care is a challenge in rural areas • Limited resources • Few diabetes programs • Lack of accessibility to speciality centers • Lack of availability • Lack of healthcare providers • Rural diabetes care is suboptimal when compared to more urban areas1

  5. Aim of the study • Assess patients’ perspectives about diabetes care • Satisfaction • Expectation • Examine attitudes in relation to: gender and educational status • Determine physician perspectives of diabetes care they provide to patients • Understand perceived barriers to diabetes care

  6. Methods • Participants • Rural patients with type 2 diabetes • Health care providers, family physicians, nurse practioners • 4 Health clinics in Northern Illinois • Patients recruited through WHO-codes • Considered to be active if visited clinic in past three years • Exclusion • < 21 years • Unable to understand English • Rurality was determined by the Rural Urban Commuting codes (RUCA) • RUCA ≥4 is considered as rural

  7. Methods • In total 1078 eligible patients • Questionnaires were mailed to participants with postage paid return envelope • Non-respondents received a reminder after three weeks • Clinic visits to leave surveys at front desk

  8. Methods • Patient Questionnaire: • General health questions • Diabetes Treatment Satisfaction Scale2 • Diabetes Attitude Scale3 • HbA1c knowledge • Check-ups related to ADA • Delgado Expectation Scale • Barrier list • Characteristics of patient • Physician Questionnaire • Diabetes control of their patients • Satisfaction about given diabetes care • Check-ups related to ADA • Delgado expectation scale • Barrier list

  9. WESP\Questionnaires\Patient Diabetes Survey 20080731.pdf

  10. Discussion • Useful to know patients’ views of their diabetes care • Care should also be focused on patients needs and expectations • Diabetes needs an interdisciplinary approach • Low response rate (16.6%) to-date? • The elderly patient • Indirect approach

  11. References • Andrus MR, Kelley KW, Murphey LM, Herndon KC. A comparison of diabetes care in rural and urban medical clinics in Alabama. J Community Health. 2004 Feb;29(1):29-44. • Bradley C, Plowright R, Stewart J, Valentine J, Witthaus E. The Diabetes Treatment Satisfaction Questionnaire change version (DTSQc) evaluated in insulin glargine trials shows greater responsiveness to improvements than the original DTSQ. Health Qual Life Outcomes. 2007;5:57. • Anderson RM, Fitzgerald JT, Funnell MM, Gruppen LD. The third version of the Diabetes Attitude Scale. Diabetes Care. 1998 Sep;21(9):1403-7.

  12. *Farewell Party* Picnic shelter Sinnissippi Park Thursday, September 18th From 5 pm till 8 pm Please let us know, if you are able to come (rein.posthuma@hotmail.com) Spouses are welcome We hope to see you!

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