Patient Assessment of Chronic Illness Care, Glycemic Control and the Utilization of Community Health Care among the Patients with Type 2 Diabetes in Shanghai, China

OBJECTIVES To evaluate the relationship between Patient Assessment of Chronic Illness Care in community health centers and self-management behaviors and glycemic control and to examine the relationship between Patient Assessment of Chronic Illness Care in community health centers and the utilization of community health centers for monitoring and treating diabetes among the patients with type 2 diabetes. METHODS A questionnaire including self-management behaviors, glycemic control, Patient Assessment of Chronic Illness Care in community health centers and the most often utilized medical institutions for monitoring and treating diabetes (community health centers vs. hospitals) was administered to 960 patients with type 2 diabetes in Shanghai, China. The relationships between Patient Assessment of Chronic Illness Care and self-management behaviors, self-management behaviors and glycemic control, Patient Assessment of Chronic Illness Care and glycemic control, Patient Assessment of Chronic Illness Care and the most often utilized medical institutions for monitoring and treating diabetes were examined. RESULTS Wilcoxon rank sum tests showed that the high scores of total Patient Assessment of Chronic Illness Care and five subscales in community health centers were positively related to almost all the proper self-management behaviors and good glycemic control (p<0.05). Almost all of the proper self-management behaviors were positively related to good glycemic control (p<0.01). High summary score of the Patient Assessment of Chronic Illness Care was positively associated with the utilization of community health centers for monitoring and treating diabetes (p<0.001). CONCLUSIONS Patient Assessment of Chronic Illness Care (implementation of the Chronic Care Model) in community health centers was associated with patients' self-management behaviors and glycemic control, and finally was associated with the utilization of community health centers for monitoring and treating diabetes.