The Efficiency of Diabetic Mellitus, Hypertension Patient Care Undertaken by Primary Care Units and Lamphun Hospital-ประสิทธิภาพของรูปแบบการดูแลผู้ป่วยเบาหวานและความดันโลหิตสูง ของสถานบริการปฐมภูมิร่วมกับโรงพยาบาลเปรียบเทียบกับรูปแบบการดูแลผู้ป่วยที่โรงพยาบาลลำพูน

Abstract

          The diabetic mellitus (DM), hypertension (HT), and atherosclerosis team of Lumphun hospital has developed a system for chronic patients since 2003, yet, without any valid evaluation. The objective of this retrospective analytical study was to compare the efficiency of the health care service provided by primary care units in collaboration with Lamphun hospital (PCU-LH) and that
by the hospital alone (LH). An extensive review of medical records in PCU/LH of two groups of 144 diabetic in patients each was carried out. Differences between the two were established by t-test and exact probability test where appropriate. The study found no statistical differences of the two groups on demographic data, and diseases/co-morbidity but on eye examination (p 0.018) and HbA1C
(p<0.001). Both groups 47 percent in LH 63 percent in PCU-LH could control the levels of fasting blood sugar (FBS) to be within normal limit (p < 0.001). No statistical differences between the two on complications, follow-up, or hospital admission could be established. Of the two equal groups of 240 HT patients, females accounted for 64 percent in LH and 75 percent in PCU-LH (p 0.010).
Differences on hyperlipidemia were also reported 32% in LH, 21% in PCU-LH (p 0.007) After services significant differences could be found between the two only on electrocardiogram (6% in LH, 1% in PCU-LH (p 0.007) and hospital admission while on differences were reported on control of blood pressure level 90% in LH, 91% in PCU-LH (p 0.0598).

           In conclusion, the health care services of DM or HT patients at primary care units were found to enhance relatively better control and hence, to refer certain patients should be recommended.

Key words: diabetic mellitus, hypertension, blood pressure, primary care unit