Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam
Abstract Background Vietnam is undergoing a rapid epidemiological transition with a considerable burden of non-communicable diseases (NCDs), especially hypertension and diabetes (T2DM). Continuity of care (COC) is widely acknowledged as a benchmark for an efficient health system. This study aimed to...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-17522-6 |
| _version_ | 1797362786288795648 |
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| author | Quynh-Anh Le Ho Thi Peter Pype Johan Wens Huy Nguyen Vu Quoc Anselme Derese Wim Peersman Nhon Bui Huyen Nguyen Thi Thanh Tam Nguyen Minh |
| author_facet | Quynh-Anh Le Ho Thi Peter Pype Johan Wens Huy Nguyen Vu Quoc Anselme Derese Wim Peersman Nhon Bui Huyen Nguyen Thi Thanh Tam Nguyen Minh |
| author_sort | Quynh-Anh Le Ho Thi |
| collection | DOAJ |
| description | Abstract Background Vietnam is undergoing a rapid epidemiological transition with a considerable burden of non-communicable diseases (NCDs), especially hypertension and diabetes (T2DM). Continuity of care (COC) is widely acknowledged as a benchmark for an efficient health system. This study aimed to determine the COC level for hypertension and T2DM within and across care levels and to investigate its associations with health outcomes and disease control. Methods A cross-sectional study was conducted on 602 people with T2DM and/or hypertension managed in primary care settings. We utilized both the Nijmegen continuity of care questionnaire (NCQ) and the Bice - Boxerman continuity of care index (COCI) to comprehensively measure three domains of COC: interpersonal, informational, and management continuity. ANOVA, paired-sample t-test, and bivariate and multivariable logistic regression analysis were performed to examine the predictors of COC. Results Mean values of COC indices were: NCQ: 3.59 and COCI: 0.77. The proportion of people with low NCQ levels was 68.8%, and that with low COCI levels was 47.3%. Primary care offered higher informational continuity than specialists (p < 0.01); management continuity was higher within the primary care team than between primary and specialist care (p < 0.001). Gender, living areas, hospital admission and emergency department encounters, frequency of health visits, disease duration, blood pressure and blood glucose levels, and disease control were demonstrated to be statistically associated with higher levels of COC. Conclusions Continuity of primary care is not sufficiently achieved for hypertension and diabetes mellitus in Vietnam. Strengthening robust primary care services, improving the collaboration between healthcare providers through multidisciplinary team-based care and integrated care approach, and promoting patient education programs and shared decision-making interventions are priorities to improve COC for chronic care. |
| first_indexed | 2024-03-08T16:12:27Z |
| format | Article |
| id | doaj.art-867f8eb55e254645a63a135044a15c72 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T16:12:27Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-867f8eb55e254645a63a135044a15c722024-01-07T12:51:51ZengBMCBMC Public Health1471-24582024-01-0124111310.1186/s12889-023-17522-6Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central VietnamQuynh-Anh Le Ho Thi0Peter Pype1Johan Wens2Huy Nguyen Vu Quoc3Anselme Derese4Wim Peersman5Nhon Bui6Huyen Nguyen Thi Thanh7Tam Nguyen Minh8Family Medicine Center, Hue University of Medicine and Pharmacy, Hue UniversityDepartment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent UniversityDepartment of Family Medicine and Population Health, University of AntwerpDepartment of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue UniversityDepartment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent UniversityResearch Group Social and Community Work, Odisee University of Applied SciencesPhu Vang District health centerFamily Medicine Center, Hue University of Medicine and Pharmacy, Hue UniversityFamily Medicine Center, Hue University of Medicine and Pharmacy, Hue UniversityAbstract Background Vietnam is undergoing a rapid epidemiological transition with a considerable burden of non-communicable diseases (NCDs), especially hypertension and diabetes (T2DM). Continuity of care (COC) is widely acknowledged as a benchmark for an efficient health system. This study aimed to determine the COC level for hypertension and T2DM within and across care levels and to investigate its associations with health outcomes and disease control. Methods A cross-sectional study was conducted on 602 people with T2DM and/or hypertension managed in primary care settings. We utilized both the Nijmegen continuity of care questionnaire (NCQ) and the Bice - Boxerman continuity of care index (COCI) to comprehensively measure three domains of COC: interpersonal, informational, and management continuity. ANOVA, paired-sample t-test, and bivariate and multivariable logistic regression analysis were performed to examine the predictors of COC. Results Mean values of COC indices were: NCQ: 3.59 and COCI: 0.77. The proportion of people with low NCQ levels was 68.8%, and that with low COCI levels was 47.3%. Primary care offered higher informational continuity than specialists (p < 0.01); management continuity was higher within the primary care team than between primary and specialist care (p < 0.001). Gender, living areas, hospital admission and emergency department encounters, frequency of health visits, disease duration, blood pressure and blood glucose levels, and disease control were demonstrated to be statistically associated with higher levels of COC. Conclusions Continuity of primary care is not sufficiently achieved for hypertension and diabetes mellitus in Vietnam. Strengthening robust primary care services, improving the collaboration between healthcare providers through multidisciplinary team-based care and integrated care approach, and promoting patient education programs and shared decision-making interventions are priorities to improve COC for chronic care.https://doi.org/10.1186/s12889-023-17522-6Continuity of careHypertensionType 2 diabetes mellitusDisease controlPrimary careVietnam |
| spellingShingle | Quynh-Anh Le Ho Thi Peter Pype Johan Wens Huy Nguyen Vu Quoc Anselme Derese Wim Peersman Nhon Bui Huyen Nguyen Thi Thanh Tam Nguyen Minh Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam BMC Public Health Continuity of care Hypertension Type 2 diabetes mellitus Disease control Primary care Vietnam |
| title | Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam |
| title_full | Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam |
| title_fullStr | Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam |
| title_full_unstemmed | Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam |
| title_short | Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam |
| title_sort | continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control insights from central vietnam |
| topic | Continuity of care Hypertension Type 2 diabetes mellitus Disease control Primary care Vietnam |
| url | https://doi.org/10.1186/s12889-023-17522-6 |
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