Variations in care of diabetes in primary care centres in Tunis

The aim of this study was to investigate the care of diabetes in primary care in the public sector in Greater Tunis and in particular, to assess variations in care across centres with the intention of seeking explanations for any differences identified. We undertook a retrospective medical review of patients with diabetes from four primary care health centres. Data were collected concerning patient characteristics, process of care criteria, outcome of care criteria, attendance rates, treatment and health centre characteristics. The total sample size was 235 patients. Outcome of care criteria were found to be similar across each of the centres. Process of care criteria were found to be significantly varied between the centres for all measurements used. Variations were also found in treatment and attendance rates across the health centres. In conclusion, there is a significant variation in the management of diabetes in primary care across centres within Greater Tunis, despite the use of standardised, national guidelines. A number of factors related to the centres may have given rise to these variations.