Evaluation process of health centers in the city of Ahar in the area of high blood pressure screening and diabetes.
Abstract
Background and Aim: Due to the implementation of the national plan for controlling
and preventing high blood pressure and diabetes, assessment and monitoring of its
implementation is of particular importance. The purpose of this study was to evaluate the
performance evaluation process of health centers in the city of Ahar in the area of high
blood pressure screening and diabetes.
Materials and Methods: This multi-stage study was carried out in parallel with two
quantitative and qualitative stages in 1396. The population of the Ahar Health Homes was
a part of the total number of other parts for the purpose of conducting an audit of the
performance of the thirty home of health in a randomized way. In order to determine the
performance status of health houses in the area of high blood pressure screening and
diabetes, information was recorded in health care homes based on the current assessment
of the performance monitoring report of health care providers by educators and experts.
T-test, a Wilcoxon ranked test, and Spearman correlation test were used to analyze the
data. In the qualitative section, the participants in this research were selected through a
targeted method and among those who were working in the health center of Ahar. Data
was collected using a focused group discussion. The number of participants varied from 7
to 10 in each group. Focused group discussion sessions were held separately on the basis
of their role in screening. Data were analyzed using content analysis method.
Results: Based on the findings of the study, the average score of health houses in relation
to high blood pressure screening standards with a score of 96.97% was lower than the
expected average by 23.4%. In the case of diabetes audits, the results also showed that
health homes in relation to diabetes screening standards were less than the expected
average by a score of 11.75% in the expert audit by an average of 24.88%. There was a
weak correlation between the scores obtained from health clinics in the high blood
pressure screening domain in the audit by an independent expert and the current
assessment, which was not statistically significant. The correlation between the ongoing
evaluation and the independent audit on diabetes screening was moderate (r = 0.351),
which was statistically significant (P = 0.049). Based on the results of the qualitative part
of the study, the problems associated with assessing diabetes screening and high blood
pressure screening were categorized in four sections including land problems, structural
problems, process and performance evaluation results.Conclusion: In this study, the achievement of the goals set in the diabetes screening and
hypertension screening program is lower than the expected national and provincial level.
Also, there was a poor correlation between evaluation of health houses in high blood
pressure and diabetes screening in independent auditors and current evaluation, which
indicates weakness and integrity in current programs of evaluating the performance of
health care providers. In order to achieve high-quality disease screening and control as the
main objective of performance evaluation, changes and revisions in supervisors' coaching
and performance evaluation system are necessary.