Health needs of diabetic patients using primary care services

Objective. To determine the extent and importance of unmet health needs of type 2 diabetic patients seen at primary care services. Material and methods. A cross-sectional study was conducted in 1999, among rural and urban patients of the Mexican Institute of Social Security, in Nuevo Leon, Mexico. The study population consisted of 256 subjects selected at random, diagnosed with type-II diabetes for at least two years. Data were obtained by interview and complemented with medical charts and provider interviews. Five health areas and four health determinants were evaluated, through Mexican Official Standards and American Diabetes Association standards of medical care for diabetic patients. Analysis consisted of descriptive statistics and estimation of z scores. Results. Health needs were met in 49% of cases, A lower mean of health need satisfaction was found in rural regions as compared to urban regions (36.8% vs. 53.3%, p < .01). Nutrition was the most affected health area (z score=-6), followed by the physical exercise (z score=-1), the metabolic health area (z score=+1), the non-smoking health area (z score=+2), the prevention and early detection of complications health area (z score=+2), and the cognitive health area (z score=+3). The health determinant with the highest requirement corresponded to utilization (z score=-5), followed by resource availability (z score=-4), perceived health need (z score=+4), and access barriers (z score= +6). Conclusions. Health need measurement allows evaluating the effectiveness of existing interventions, in addition to identifying areas with higher unmet health needs. These findings facilitate analysis and decision-making to devise specific health policies and actions directed at improving the quality of care for diabetic patients. The English version of this paper is available at: http://www.insp.mx/salud/index.html.