Quality of previous diabetes care among patients receiving services at ophthalmology hospitals in Mexico Calidad de la atención previa de los pacientes diabéticos atendidos en hospitales de oftalmología en México

• Main Authors: Joel Rodríguez-Saldana, Andrea C Rosales-Campos, Carmen B. Rangel León, Laura I Vázquez-Rodríguez, Francisco Martínez-Castro, John D Piette
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2010
• Subjects: Diabetes mellitus tipo 2; complicaciones de la diabetes; retinopatía diabética; calidad de la atención de salud; México; Diabetes mellitus; type 2; diabetes complications; diabetic retinopathy; quality of health care; Mexico; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/d3bb771b753641aea34d651e29ca5b8e

OBJECTIVE: To survey a large sample of type 2 diabetes mellitus (T2DM) patients in Mexico City to determine if patient experience, access to basic services, treatment, and outcomes differed between those with social security coverage and those without. METHODS: From 2001-2007 a total of 1 000 individuals with T2DM were surveyed in outpatient clinics of the three largest public ophthalmology hospitals in Mexico City. Patients reported information about their health status and receipt of basic diabetes services, such as laboratory glycemic monitoring and diabetes education. Rates were compared between those with (n = 461) and without (n = 539) social security. RESULTS: Almost half of the patients (46%) in these public facilities were social security patients that were unable to access other services and had to pay out-of-pocket for care. Half of respondents were originally identified as potentially diabetic based on symptom complaints (51%), including 11% with visual impairment. Most patients (87.9%) reported that their glycemic level was being monitored exclusively via fasting blood glucose testing or random capillary blood glucose tests; only 5.3% reported ever having a glycated hemoglobin test. While nearly all respondents reported an individual physician encounter ever, only 39% reported ever receiving nutrition counseling and only 21% reported attending one or more sessions of diabetes education in their lifetime. Processes of care and outcomes were no different in patients with and those without social security coverage. CONCLUSIONS: In Mexico, the quality of diabetes care is poor. Despite receiving social security, many patients still have to pay out-of-pocket to access needed care. Without policy changes that address these barriers to comprehensive diabetes management, scientific achievements in diagnosis and pharmacotherapy will have limited impact OBJETIVO: Determinar si hay diferencias en cuanto a las experiencias de atención de la diabetes, el acceso a los servicios básicos, el tratamiento y la ...