Quality of care and cost of prescriptions for diabetes and hypertension at primary healthcare facilities in the Cape Town Metropole

Abstract

Background: Quality of care for diabetes and hypertension has been found to be sub optimal at PHC level. There is an expectation that improving quality will require increased utilization of resources. This research was intended to determine the quality of care and cost of prescriptions at ten facilities in the Cape Town Metropole. Methods: An analytical, cross-sectional study was conducted in order to relate the cost of medication to quality of care indicators for patients with diabetes and hypertension. Data were collected at the 10 facilities in the Cape Town Metropole over a three-month period. Results: Quality-of-care processes were performed more often in diabetic than hypertensive patients, i.e. (BMI) 52.4% vs. 46.4%, creatinine 45.2% vs. 35.7% and cholesterol 44.5% vs. 35.4%. Nevertheless, outcome measures were better amongst hypertensive patients. Targets were achieved in hypertensive vs. diabetic patients, respectively, as follows: BMI (22.2% vs. 18.1%), blood pressure (39.8% vs. 28.7%), creatinine (93.2% vs. 91.4%) and cholesterol (46.8% vs. 44%). The median cost per script was R44.66 and R30.06 for diabetic and hypertensive patients with good quality-of-care scores, respectively and R51.18 and R31.00, for those with poor quality-of-care scores. Conclusions: The quality of care provided was poor when compared with guideline recommendations, but was comparable to care provided in many other populations. There was no correlation between quality of care and the cost of prescriptions. (Full text available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2015; DOI: 10.1080/20786190.2014.976988