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Diabetes self-care is vital to overall management of diabetes and to optimization of disease-related outcomes. In China, community health service institution played an important role on diabetes prevention and control.The aims of this study were to examine whether patients consult their general practitioners (GPs) in community for diabetes frequently, whether increase in the number of attendance led to better diabetic self-care, and do reasons for infrequent consultation vary between community patients in urban and rural areas in China.
Between October 2014 and November 2014, a cross-sectional study was undertaken of diabetes patients living in the urban and rural communities of Shandong and Jiangsu province in China. Measures included demographic factors, self-care behaviors, and frequency of attendance at community clinics. The impact of frequency of attendance on self-care among diabetic patients was assessed using multiple logistic regression analysis.
Of the 1508 patients (mean age 64.4±10.6) who participated, 40.1% were male and 49.4% were urban. A total of 825 patients (54.7%) visited the community clinic four or more times in the past 12 months. The increased number of community clinic attendance was associated with the improvement of diabetes self-care. Reasons of failure to attend clinics identified in urban patients include scarcity of diabetes medicines in the community, long distance from home to community clinics, and low quality of chronic disease care in community. For the rural patients, worrying about the medical expenses and drug scarce were the most common barriers for community clinic attendance.
Significant correlates between frequent attendance and high compliance to self-care may help with intervention of patients who may benefit from strategies aimed at enhancing service utilization in community health centers.