Abstract
The objective of this study was to explore the performance of the diabetic patients’
care system that referred patients to the primary care unit (PCU) in the Kantang network
health service one year ago. It was to compare the output of care between, before and
after patients were referred for diabetic care from Kantang Hospital to the PCU. A self-administered questionnaire, using the PRECEDE PROCEED Model, was used
among 14 PCU personnel and 97 patients between October 1 and 31, 2007. The study
found that most of the participants were in the age group 41-55 years (40.2%), females
reprecented the majority of them at 79.4 percent, couples at 81.4 percent, the level of education
at the primary school level at 76.3 percent, agricultural occupation at 32.0 percent,
duration of disease 1-5 years at 83.5 percent. The participants with no related disease
comprised 51.5 percent of the total; those with hypertension, 32.0 percent, normal body
mass index (BMI), 55.7 percent and higher level at 41.2 percent. The levels of blood sugar
both before and after referral were not different. Loss to follow-up after referral decreased
significantly (p-value < 0.05). The level of knowledge about diabetes was found to be at
high at 76.63 percent. With regard to the level of behavior for diabetic control, the highest
behavior was drug use at 92.58 percent; the least behavior that patients performed was
exercise activity at 52.80 percent. The association between knowledge and behavior with
regard to eating, drug use and general health care was moderate, but with stress management,
low there seemed to be no effect on exercise activity behavior. Concerning the
service that patients got at the PCU after referral, almost all items were high at more than
90 percent, except participation in group practice activity, which was moderate at 14.4
percent. The level of the patients’ satisfaction toward the service was found to be moderate
to high, at 86.94 percent.
The overall findings indicated that the output of care both at the DM clinic in the
hospital and the PCU was not different; thus, this system can continue to perform but
there should be concern about the problems and attendance.
