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Family Practice Vol. 17, No. 2, 167-172
© Oxford University Press 2000

Quality of life and effectiveness of diabetes care in three different settings in Leuven

H Van Loona, L Deturckb, F Buntinxa, J Heyrmana, L Degrooteb, K De Kokerb and J Vliersb

a Department of General Practice, KULeuven, Kapucijnenvoer 33 and
b Medisch Centrum voor Huisartsen, Leuven, Belgium.

Background. The new diabetes protocol, formulated in Belgium as a consensus between the National Institution of Health Insurance and diabetologists, implicitly assumes the care of type 1 diabetic patients to be more efficient at the specialist level (SP) in hospital, although GPs frequently are involved in diabetes care.

Objectives. A study was carried out in order to highlight differences in diabetes care between three different treatment settings (SP alone, combined SP–GP and GP alone)

Methods. Out of a group of known diabetics, 325 patients were selected according to a stratified cluster sampling technique, in such a way that the three types of diabetes (formerly called type 1, type 2a and type 2b) occurred sufficiently in the three above-defined treatment settings. Outcome data on co-morbidity and diabetes health profile as well as output data on laboratory results were collected for each patient and compared between the different subgroups.

Results. On the basis of a response rate of 47.9%, equally distributed over the different levels, we demonstrated that GPs and SPs score equally low on the different measures and that a better follow-up is indicated in all settings.

Conclusion. Diabetes care in Flanders can be upgraded significantly. There is no evidence that specialists are performing better. Therefore, one could argue for better follow-up of diabetes care in a primary health care setting.

Keywords. Belgium, diabetes care, effectiveness, quality of life.


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