A comparative study of the results of NCD Clinic service indicators in hospitals under the Office of the Permanent Secretary, of Chachoengsao Province, fiscal year 2024

Abstract

This mixed-methods study employed a convergent parallel design to (1) compare service outcome indicators related to glycated hemoglobin (HbA1c) control among diabetic patients aged below 60 years and those aged 60 years and above across hospitals in Chachoengsao Province; (2) examine the operational model of NCD Clinic Plus in terms of service systems and personnel; and (3) analyze the relationship between HbA1c control outcomes and service system and policy-related factors. The quantitative component was a total population study of 43,873 patients, without sampling. Data were obtained from the Data Exchange system within the Health Data Center between October 2023 and March 2024. Descriptive statistics and the Kruskal–Wallis test were applied, with effect size (η²) reported. The qualitative component involved in depth interviews with one clinic nurse from each of 11 hospitals. The interview guide demonstrated perfect content validity (IOC = 1.00), and data were analyzed using content analysis before being integrated with quantitative findings. The results revealed statistically significant differences in HbA1c control across hospitals. Qualitative findings indicated that multidisciplinary service models, the application of DM Remission approaches, and supportive policies were associated with better outcomes. Enhancements in information systems, adoption of digital technologies, and community engagement were also identified as key strategies for strengthening and sustaining high quality NCD care.