Follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China

Abstract Background Follow-up care is crucial but challenging for disease management particularly in rural areas with limited healthcare resources and clinical capacity, yet few studies have been conducted from the perspective of rural primary care physicians (PCPs). We assessed the frequency of fol...

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Autores principales:	Yi Wang, Xiu-Jing Hu, Harry H. X. Wang, Hong-Yan Duan, Ying Chen, Yu-Ting Li, Zi-Lin Luo, Xin Li, Jia-Ji Wang, Stewart W. Mercer
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Follow-up care delivery Hypertension Type 2 diabetes Treatment goal Target non-attainment Rural area Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7c67c11715ba405c9dcca7e0d9224bce
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spelling	oai:doaj.org-article:7c67c11715ba405c9dcca7e0d9224bce2021-11-14T12:32:29ZFollow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China10.1186/s12875-021-01564-z1471-2296https://doaj.org/article/7c67c11715ba405c9dcca7e0d9224bce2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12875-021-01564-zhttps://doaj.org/toc/1471-2296Abstract Background Follow-up care is crucial but challenging for disease management particularly in rural areas with limited healthcare resources and clinical capacity, yet few studies have been conducted from the perspective of rural primary care physicians (PCPs). We assessed the frequency of follow-up care delivered by rural PCPs for hypertension and type 2 diabetes – the two most common long-term conditions. Methods We conducted a multi-centre, self-administered survey study built upon existing general practice course programmes for rural PCPs in four provinces. Information on follow-up care delivery were collected from rural PCPs attending centralised in-class teaching sessions using a set of close-ended, multiple choice questions. Binary logistic regression analysis was performed to examine physician-level factors associated with non-attainment of the target frequency of follow-up care for hypertension and type 2 diabetes, respectively. The final sample consisted of rural PCPs from 52 township-level regions. The Complex Samples module was used in the statistical analysis to account for the multistage sample design. Results The overall response rate was 91.4%. Around one fifth of PCPs in rural practices did not achieve the target frequency of follow-up care delivery (18.7% for hypertension; 21.6% for type 2 diabetes). Higher education level of physicians, increased volume of daily patients seen, and no provision of home visits were risk factors for non-attainment of the target frequency of follow-up care for both conditions. Moreover, village physicians with less working experiences tended to have less frequent follow-up care delivery in type 2 diabetes management. Conclusions Efforts that are solely devoted to enhancing rural physicians’ education may not directly translate into strong motivation and active commitment to service provision given the possible existence of clinical inertia and workload-related factors. Risk factors identified for target non-attainment in the follow-up care delivery may provide areas for capacity building programmes in rural primary care practice.Yi WangXiu-Jing HuHarry H. X. WangHong-Yan DuanYing ChenYu-Ting LiZi-Lin LuoXin LiJia-Ji WangStewart W. MercerBMCarticleFollow-up care deliveryHypertensionType 2 diabetesTreatment goalTarget non-attainmentRural areaMedicine (General)R5-920ENBMC Family Practice, Vol 22, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Follow-up care delivery Hypertension Type 2 diabetes Treatment goal Target non-attainment Rural area Medicine (General) R5-920
spellingShingle	Follow-up care delivery Hypertension Type 2 diabetes Treatment goal Target non-attainment Rural area Medicine (General) R5-920 Yi Wang Xiu-Jing Hu Harry H. X. Wang Hong-Yan Duan Ying Chen Yu-Ting Li Zi-Lin Luo Xin Li Jia-Ji Wang Stewart W. Mercer Follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China
description	Abstract Background Follow-up care is crucial but challenging for disease management particularly in rural areas with limited healthcare resources and clinical capacity, yet few studies have been conducted from the perspective of rural primary care physicians (PCPs). We assessed the frequency of follow-up care delivered by rural PCPs for hypertension and type 2 diabetes – the two most common long-term conditions. Methods We conducted a multi-centre, self-administered survey study built upon existing general practice course programmes for rural PCPs in four provinces. Information on follow-up care delivery were collected from rural PCPs attending centralised in-class teaching sessions using a set of close-ended, multiple choice questions. Binary logistic regression analysis was performed to examine physician-level factors associated with non-attainment of the target frequency of follow-up care for hypertension and type 2 diabetes, respectively. The final sample consisted of rural PCPs from 52 township-level regions. The Complex Samples module was used in the statistical analysis to account for the multistage sample design. Results The overall response rate was 91.4%. Around one fifth of PCPs in rural practices did not achieve the target frequency of follow-up care delivery (18.7% for hypertension; 21.6% for type 2 diabetes). Higher education level of physicians, increased volume of daily patients seen, and no provision of home visits were risk factors for non-attainment of the target frequency of follow-up care for both conditions. Moreover, village physicians with less working experiences tended to have less frequent follow-up care delivery in type 2 diabetes management. Conclusions Efforts that are solely devoted to enhancing rural physicians’ education may not directly translate into strong motivation and active commitment to service provision given the possible existence of clinical inertia and workload-related factors. Risk factors identified for target non-attainment in the follow-up care delivery may provide areas for capacity building programmes in rural primary care practice.
format	article
author	Yi Wang Xiu-Jing Hu Harry H. X. Wang Hong-Yan Duan Ying Chen Yu-Ting Li Zi-Lin Luo Xin Li Jia-Ji Wang Stewart W. Mercer
author_facet	Yi Wang Xiu-Jing Hu Harry H. X. Wang Hong-Yan Duan Ying Chen Yu-Ting Li Zi-Lin Luo Xin Li Jia-Ji Wang Stewart W. Mercer
author_sort	Yi Wang
title	Follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China
title_short	Follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China
title_full	Follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China
title_fullStr	Follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China
title_full_unstemmed	Follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China
title_sort	follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in china
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7c67c11715ba405c9dcca7e0d9224bce
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Follow-up care delivery in community-based hypertension and type 2 diabetes management: a multi-centre, survey study among rural primary care physicians in China

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