Team-based care improves quality of diabetes care -Family Practice Integrated Care Project in Taiwan

BMC Fam Pract. 2020 Oct 15;21(1):209. doi: 10.1186/s12875-020-01284-w.

Abstract

Background: The Family Practice Integrated Care Project (FPICP) is a team-based program in Taiwan initiated in 2003. This study investigates the influence of FPICP on the quality of diabetes care.

Methods: This population-based cohort study used Taiwan's National Health Insurance Administration data on FPICP (fiscal year 2015-2016, with follow-up duration of one year). Participants included diabetic patients aged ≥30 in primary care clinics. We used conditional logistic regression modeling of patient characteristics and annual diabetes examinations and compared FPICP participants with non-participating candidates. Main outcome measures included completion of annual diabetes examinations, including glycated hemoglobin (A1c), low-density lipoprotein (LDL), urine microalbumin (MAU), routine urinalysis (UR), and fundus examination (FE).

Results: The sample included 298,208 FPICP participants and 478,778 non-participating candidates. After 1:1 propensity score matching, the examination completion rates for FPICP participants and non-participants, respectively, were 94.4% versus 93.6% in A1c, 84.2% versus 83.8% in LDL, 61.9% versus 60.1% in MAU, 59.2% versus 58.0% in UR, and 30.1% versus 32.4% in FE.

Conclusion: Our findings indicate that a program like FPICP helps improve the quality of diabetes care through regular examinations of Alc, LDL, MAU, and UR.

Keywords: Delivery of health care; Diabetes mellitus; Family practice integrated care project; Policy; Primary health care; Quality of health care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Delivery of Health Care, Integrated*
  • Diabetes Mellitus* / therapy
  • Diabetes Mellitus, Type 2*
  • Family Practice
  • Glycated Hemoglobin / analysis
  • Humans
  • Taiwan

Substances

  • Glycated Hemoglobin A