Determinants of quality of care offered to diabetes mellitus patients receiving care from Kawempe national referral hospital Kampala Uganda

Abstract

It is estimated that over 382 million adults are suffering from Diabetes Mellitus, with a prevalence of 8.3% globally. It is also projected that the number of patients having Diabetes Mellitus will double by the year 2030, and in 25 years‘ time the number will have raised to 592 million people. Similarly, in Sub-Saharan Africa, 19.8 million people are diagnosed with Diabetes Mellitus, with a prevalence of 5.1%, this is expected to double by the year 2035. To establish the determinants of the quality of care offered to Diabetes Mellitus Patients receiving care from Kawempe National Referral Hospital, Kampala-Uganda. A cross-sectional quantitative study in which an interviewer administered questionnaire and a checklist were used to collect data from 97 diabetic patients receiving care from Kawempe National Referral Hospital Diabetes Mellitus clinic. Consecutive sampling technique was used to select the study participants until the required sample size was reached. Quality control was done before, during and after data collection to ensure that the data is free of bias and ensure that there is no information that is missing. Data entry, storage and analysis was done with Microsoft excel 2010. Uniformity, accuracy, consistency, comprehensibility, missing data, double entries to set it ready for analysis and data was later imported to STATA version 13 for data analysis. It was found out that only 40.2% of the patients received good quality care and the factors associated with the quality of care included Marital status (aOR=4.0,95%CI: 1.2-13.0, p=0.020), Occupation (aOR=20.6; 95%CI:2.4-175.8, p=0.006), Family support (aOR=1.9; 95%CI:1.74-13.8, p=0.023), distance to health facility (aOR=13.8; 95%CI; 1. 87-21.80, p=0.02). Provision of counseling to the patients (aOR=4; 95%CI; 1.4-40.0, p=0.024), giving reminders on appointment date (aOR=2.2; 95%CI; 1.6-8.4, p=0.03) health education compared to the ones that were not health educated (aOR=0.04; 95%CI; 0.01-0.22, p=0.000) and drug stock out (aOR=3; 95%CI; 0.1-0.72, p=0.081). The study concludes that the quality of the care provided to the DM patients at Kawempe National Referral Hospital was generally poor and the determinants associated with the quality of care provided to DM patients included: marital status, occupation, family support and the distance from home to health facility, counseling, health education to the patients, giving reminders on the appointment dates and drug stock outs. The study therefore, recommends that Continuous in-service training for health-care workers on Diabetic client‘s quality of care, professionalism, giving reminders to the patients, family support, counseling and health education could be done to improve the quality of care.