Lastly, it enacted a series of policies to implement the core functions of PHC in community health centers (CHCs) since the first official national policy in 1999 and especially improved the quality and quantity of CHCs since the health reform of 2009. Third, it implemented the Family Doctor Program, which provides effective health management to those who have signed up with a family doctor. Second, it established a universal health insurance coverage program and the National Essential Medicine Program, which reduce the financial burden and provide fundamental medical security for patients. First, it launched the Basic Public Health Service Program, which lists diabetes as a key condition for chronic disease management. For better implementation of the reform, the Chinese government has put forward a series of policies and pilot programs. In fact, in China’s latest round of health system reform since 2009, enormous efforts have been made to revitalize the country’s PHC program, with the vision of forging a PHC-based integrated delivery system where PHC facilities serve as gatekeepers and secondary and tertiary hospitals provide specialized care. As the prevalence rate of diabetes is expected to increase significantly in middle-income countries over the next 25 years, health policy-makers in LMICs should find appropriate solutions to manage the disease. Undoubtedly, DM has emerged as a great challenge to all countries, particularly low- and middle-income countries (LMICs). Even worse is that people living with DM are at increased risk of severe illness and death due to COVID-19. In addition, early deaths due to diabetes were noted to increase by 5% between 20, whereas premature mortality due to other major noncommunicable diseases is decreasing. According to the report released by the International Diabetes Federation in 2019, ~463 million adults aged between 20 and 79 years worldwide, constituting ~6% of the global population, are struggling with type 1 or 2 diabetes mellitus (DM) this indicates that 1 in 11 people has diabetes globally. In 2021, the World Health Organization (WHO) raised the priority given to the prevention, control, and management of diabetes as well as its risk factors with the aim of expediting the necessary actions for diabetes management moving forward, 100 years after the discovery of insulin. In particular, family-centered and community-oriented CHCs may help improve diabetes management in China and other low- and middle-income countries. Better PHC experiences were associated with better diabetes management. Especially, the aORs for those with good glycemic control were 3.92 (95% CI = 2.38–6.44) and 4.73 (95% CI = 2.73–8.20) per dimensional PCAT score of family-centeredness and community orientation increasing, respectively. For example, compared to those with poor glycemic control, the aORs for those with good glycemic control was 8.82 (95% CI = 4.38–17.76) per total PCAT score increasing. Higher PCAT scores were significantly associated with a greater adjusted odds ratios (aORs) of good glycemic control for total and dimensional PCAT scores. The patients with good glycemic control had significantly higher total and dimensional PCAT scores compared with those with poor glycemic control ( p < 0.05). Binary logistic regression analyses were conducted to assess the associations between the patients’ PHC experiences and glycemic control status, adjusting for covariates. We evaluated their PHC experiences using the Primary Care Assessment Tool (PCAT) developed by Johns Hopkins and assessed their glycemic control status by measuring their fasting plasma glucose levels. In total, 418 patients with diabetes mellitus (44% males and 56% females) were recruited between August and October 2019. This study was conducted in six CHCs in the Greater Bay Area of China. In this study, we explored the associations between experiences of PHC in CHCs and glycemic control status in patients with diabetes mellitus. However, few studies have discussed the association between the service quality of PHC and the effects of diabetes management. Primary healthcare (PHC) plays an important role in diabetes management community health centers (CHCs) serve as the main providers of PHC.
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