The role of primary physician training in improving regional standardized management of diabetes: a pre-post intervention study

BACKGROUND: Hierarchical diagnosis and treatment has been gradually implemented throughout the China. Primary physicians are the main force in primary-level medical and health services, which means that standardized training of primary-level doctors is indispensable. OBJECTIVES: Evaluation of the effect of primary physician training on standardized management of diabetes, and comparison of the effects of different training models. METHOD: The study selected 24 community health service centers from 4 cities in Liaoning Province, and consisted of two groups: primary physicians (n = 2083) who received training; and patients with diabetes (n = 585) in community health service centers. Short-term training effects on primary physicians were assessed through diabetes knowledge tests at baseline and at the end of training; the long-term effects of training on patients with diabetes were assessed by questionnaires at baseline and 1 year after training. The differences in training effects between different training models were compared. Complication screening results were also assessed. RESULTS: After training, the primary physicians’ knowledge of diabetes diagnosis and treatment improved (p < 0.05). The complication screening rate of local diabetes patients increased from 22.2% before training to 27.7% 1 year after training (p = 0.033). There were significant differences in the training effect between different training models (p = 0.038). The short-term intensive training group demonstrated the greatest training effect, primary physicians under this training model are more likely to conduct standardized screenings for patients (OR = 1.806, 95%CI 1.008–3.233), and the complication screening rate was the highest (37.6%). CONCLUSION: This study shows that training of primary physicians is an effective way to improve the standardized management of diabetes, by improving the ability of primary physicians to manage diabetes in a standardized manner, so that patients in primary hospitals receive more comprehensive diagnosis and treatment services. Compared with scattered training throughout the year, short-term intensive training was found to be more effective. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-022-01663-5.