PMID- 21308170
OWN - NLM
STAT- MEDLINE
DCOM- 20110614
LR  - 20190517
IS  - 1680-5348 (Electronic)
IS  - 1020-4989 (Linking)
VI  - 28
IP  - 6
DP  - 2010 Dec
TI  - Quality of previous diabetes care among patients receiving services at 
      ophthalmology hospitals in Mexico.
PG  - 440-5
LID - S1020-49892010001200005 [pii]
AB  - OBJECTIVE: To survey a large sample of type 2 diabetes mellitus (T2DM) patients 
      in Mexico City to determine if patient experience, access to basic services, 
      treatment, and outcomes differed between those with social security coverage and 
      those without. METHODS: From 2001-2007 a total of 1 000 individuals with T2DM 
      were surveyed in outpatient clinics of the three largest public ophthalmology 
      hospitals in Mexico City. Patients reported information about their health status 
      and receipt of basic diabetes services, such as laboratory glycemic monitoring 
      and diabetes education. Rates were compared between those with (n = 461) and 
      without (n = 539) social security. RESULTS: Almost half of the patients (46%) in 
      these public facilities were social security patients that were unable to access 
      other services and had to pay out-of-pocket for care. Half of respondents were 
      originally identified as potentially diabetic based on symptom complaints (51%), 
      including 11% with visual impairment. Most patients (87.9%) reported that their 
      glycemic level was being monitored exclusively via fasting blood glucose testing 
      or random capillary blood glucose tests; only 5.3% reported ever having a 
      glycated hemoglobin test. While nearly all respondents reported an individual 
      physician encounter ever, only 39% reported ever receiving nutrition counseling 
      and only 21% reported attending one or more sessions of diabetes education in 
      their lifetime. Processes of care and outcomes were no different in patients with 
      and those without social security coverage. CONCLUSIONS: In Mexico, the quality 
      of diabetes care is poor. Despite receiving social security, many patients still 
      have to pay out-of-pocket to access needed care. Without policy changes that 
      address these barriers to comprehensive diabetes management, scientific 
      achievements in diagnosis and pharmacotherapy will have limited impact.
FAU - Rodriguez-Saldana, Joel
AU  - Rodriguez-Saldana J
AD  - Centro Multidisciplinario de Diabetes de la Ciudad de Mexico, Resultados Medicos, 
      Desarrollo e Investigacion, Mexico City, Mexico. joelrds.coatlicue@prodigy.net.mx
FAU - Rosales-Campos, Andrea C
AU  - Rosales-Campos AC
FAU - Rangel Leon, Carmen B
AU  - Rangel Leon CB
FAU - Vazquez-Rodriguez, Laura I
AU  - Vazquez-Rodriguez LI
FAU - Martinez-Castro, Francisco
AU  - Martinez-Castro F
FAU - Piette, John D
AU  - Piette JD
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Rev Panam Salud Publica
JT  - Revista panamericana de salud publica = Pan American journal of public health
JID - 9705400
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Aged
MH  - Blood Glucose/analysis
MH  - Counseling/statistics & numerical data
MH  - Diabetes Mellitus, Type 2/blood/diagnosis/*drug therapy/economics/epidemiology
MH  - Diabetic Retinopathy/*drug therapy/economics/epidemiology
MH  - Female
MH  - Health Expenditures/statistics & numerical data
MH  - Health Surveys
MH  - Hospitals, Special/economics/*statistics & numerical data
MH  - Hospitals, Urban/economics/*statistics & numerical data
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/therapeutic use
MH  - Male
MH  - Mexico/epidemiology
MH  - Middle Aged
MH  - *Ophthalmology
MH  - Patient Education as Topic
MH  - *Quality of Health Care
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Social Security/economics/statistics & numerical data
MH  - Socioeconomic Factors
EDAT- 2011/02/11 06:00
MHDA- 2011/06/15 06:00
CRDT- 2011/02/11 06:00
PHST- 2010/03/03 00:00 [received]
PHST- 2010/08/09 00:00 [accepted]
PHST- 2011/02/11 06:00 [entrez]
PHST- 2011/02/11 06:00 [pubmed]
PHST- 2011/06/15 06:00 [medline]
AID - S1020-49892010001200005 [pii]
PST - ppublish
SO  - Rev Panam Salud Publica. 2010 Dec;28(6):440-5.