Diabetes Mellitus Clinical Trial
Official title:
Evaluation of Quality of Care - Shared-Care Programme, HA
Diabetes mellitus (DM) and hypertension (HT) are major causes of morbidity and among the top
10 causes of deaths in Hong Kong in 2008 (Department of Health 2009). The Hospital Authority
(HA) has initiated service improvement through introducing the shared-care (SC) programme to
improve the quality of care (QOC) for DM and HT patients. The evaluation on the QOC is an
essential part of the programme in order to inform future policy. The Family Medicine Unit
(FMU) of the University of Hong Kong (HKU) has been appointed by the HA to carry out the
evaluation of the QOC of the programme.
The Action Learning and Audit Spiral methodologies to measure whether the target standard of
care intended by the SC programme is achieved. Each SC participating clinic and private
medical practitioner (PMP) will be invited to complete a structured evaluation questionnaire.
The data of all patients who have enrolled into the programme will be included in the
evaluation on the process and outcomes of care. A hundred and thirty participants will be
followed up by telephone to evaluate the effect of the programme in quality of life (QOL),
patient enablement, and global rating of change in health condition at baseline and 6 months
after enrolment. Data on the process of care will be retrieved from the HA medical records.
Main Outcome Measures: The primary outcomes are the proportion of participants who received
the criterion process of care and achieved a HbA1c level <7.5%.
Data Analysis: Descriptive statistics on proportions of clinics or subjects meeting the
quality of care criteria will be calculated. The outcomes of SC patients will be compared at
6, 12, 24, 36 and 48 months by paired sample t-test. The outcomes between SC patients and
control group will be compared by independent sample t-test or Chi-square test.
Hypothesis: The QOC of the SC programme will be determined. Areas of deficiency and possible
areas for quality enhancement will be identified. The results of this study will provide
empirical evidence on whether the HA's SC programme can achieve equivalent QOC as the usual
HA care for diabetes mellitus (DM) patients. The information will be used to guide service
planning and policy decision making.
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