Quality of Life and Quality of Care in Patients With Diabetes Experiencing Different Models of Care

OBJECTIVE: To study variation in quality of life and quality of care in patients with diabetes experiencing three different models of care: traditional hospital care, hospital/general practitioner (GP) shared care, and structured GP care. RESEARCH DESIGN AND METHODS: A cross-sectional study involving 1,456 patients with diabetes (71% response rate) was conducted. Quality of life was assessed with the Audit of Diabetes-Dependent Quality of Life (ADDQoL) instrument and quality of care with a 10-point process-of-care report card. RESULTS: The adjusted odds ratio (OR) for a high (upper quartile) ADDQoL score was significantly increased in the structured care relative to the traditional hospital care group (OR 1.7 [95% CI 1.2–2.5]). A significantly higher proportion of structured GP care patients reported compliance with seven or more key process-of-care measures compared with the other models of care. CONCLUSIONS: Diabetes quality of life may be enhanced when care is provided in a primary care setting without compromising quality of care.