Quality of life and quality of care in patients with diabetes experiencing different models of care.

Abstract

To study variation in quality of life and quality of care in patients with diabetes experiencing three different models of care: traditional hospital care, hospital/general practitioner (GP) shared care, and structured GP care. A cross-sectional study involving 1,456 patients with diabetes (71% response rate) was conducted. Quality of life was assessed with the Audit of Diabetes-Dependent Quality of Life (ADDQoL) instrument and quality of care with a 10-point process-of-care report card. The adjusted odds ratio (OR) for a high (upper quartile) ADDQoL score was significantly increased in the structured care relative to the traditional hospital care group (OR 1.7 [95% CI 1.2-2.5]). A significantly higher proportion of structured GP care patients reported compliance with seven or more key process-of-care measures compared with the other models of care. Diabetes quality of life may be enhanced when care is provided in a primary care setting without compromising quality of care.