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Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran

BACKGROUND: Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying opera...

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Autores principales: Mahdavi, Mahdi, Parsaeian, Mahboubeh, Borzouei, Shiva, Majdzadeh, Reza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406836/
https://www.ncbi.nlm.nih.gov/pubmed/34461877
http://dx.doi.org/10.1186/s12913-021-06932-0
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author Mahdavi, Mahdi
Parsaeian, Mahboubeh
Borzouei, Shiva
Majdzadeh, Reza
author_facet Mahdavi, Mahdi
Parsaeian, Mahboubeh
Borzouei, Shiva
Majdzadeh, Reza
author_sort Mahdavi, Mahdi
collection PubMed
description BACKGROUND: Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience. METHODS: We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software. RESULTS: After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making). CONCLUSIONS: Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06932-0.
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spelling pubmed-84068362021-08-31 Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran Mahdavi, Mahdi Parsaeian, Mahboubeh Borzouei, Shiva Majdzadeh, Reza BMC Health Serv Res Research BACKGROUND: Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience. METHODS: We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software. RESULTS: After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making). CONCLUSIONS: Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06932-0. BioMed Central 2021-08-31 /pmc/articles/PMC8406836/ /pubmed/34461877 http://dx.doi.org/10.1186/s12913-021-06932-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Mahdavi, Mahdi
Parsaeian, Mahboubeh
Borzouei, Shiva
Majdzadeh, Reza
Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran
title Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran
title_full Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran
title_fullStr Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran
title_full_unstemmed Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran
title_short Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran
title_sort identifying associations between health services operational factors and health experience for patients with type 2 diabetes in iran
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406836/
https://www.ncbi.nlm.nih.gov/pubmed/34461877
http://dx.doi.org/10.1186/s12913-021-06932-0
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