Study of the quality of care at a diabetic clinic in Sri Lanka.

The aim was to study the quality of care at a diabetic clinic of a large hospital in Sri Lanka; a sample of 200 patients was randomly selected. A questionnaire was designed to assess patient knowledge of diabetic management and service provision. Clinic attendance records were also used. Measures of outcome were taken to be (i) the patient's level of understanding of their condition, (ii) the availability of diagnostic tests, (iii) the provision of regular screening and (iv) the length of consultation time. The average attendance at each four-hour clinic was 174 patients. With three doctors available, average consultation time was four minutes per patient. Procedures undertaken included measuring blood glucose levels, testing for proteinuria and screening for hyperlipidaemia, hypertension and eye disease. The average score for knowledge regarding management and complications, obtained from analysis of the questionnaire, was 5.3 out of a maximum of 9.0 points. The study showed that the quality of care of diabetic patients did not meet the standards that should be expected. Two of the principal problems were lack of good organisation and poor planning of resource utilisation. An increase in funding would, of course, assist in implementing the improvements suggested.