Diabetes Care and Treatment System Entry and Retaining Cycle: a Case Study in Thailand

Abstract

Type 2 diabetes is a significant public health issue worldwide and in Thailand. Patients with diabetes who do not receive proper and correct care may develop complications such as abnormal retinal conditions, kidney disease, cerebrovascular and heart diseases, and foot complications. This research aims to study the diabetic patient journey in the Thai population. It is an analytical cross-sectional study, an exploratory survey in Nakhon Sawan, Phitsanulok, Nakhon Ratchasima, and Bangkok. The study looks at the perspectives of both service users and providers. There were 66 samples from service providers in hospitals and communities (Village Health Volunteers), and 265 samples from service users (those at risk of diabetes, pre-diabetic, and diabetic patients), totaling 331 individuals. The patient journey applied the Reach – Recruit – Test – Treat – Retain (RRTTR) measures. The study found that from both perspectives, access to diabetes screening services (Reach) and diabetes screening (Test) was over 95%. Those screened into the care process (Treat) fell into two groups: 1) those at risk and pre-diabetic entered the Loop T0 cycle, which is a health promotion process, at 100%, and 2) diabetic patients entered the Loop T1 cycle, which is a treatment and care process, and remained in the system (Retain) at over 85%. According to service providers, only 68.2% of diabetic patients came for treatment, due to reasons such as working away from home, forgetting appointment dates, and having leftover medication. The study’s recommendations include considering the development of guidelines and a system for registering and screening services, and developing the linked national diabetes database for seamless treatment system.