Resource allocation and organisational features in Swedish primary diabetes care: Changes from 2006 to 2013

Published:August 28, 2016DOI:


      • Examined changes in Swedish primary diabetes care between 2006 and 2013 using self-reported data.
      • List size decreased while the number of patients with type 2 diabetes (T2DM) increased.
      • RNs’ time devoted to patients with T2DM and diabetes-specific education levels increased.
      • Use of follow-up systems and medical check-ups for risk factors increased.
      • Use of group education programmes and patient participation in setting treatment targets remained low.



      To compare the resource allocation and organisational features in Swedish primary diabetes care for patients with type 2 diabetes mellitus (T2DM) between 2006 and 2013.


      Using a repeated cross-sectional study design, questionnaires covering personnel resources and organisational features for patients with T2DM in 2006 and 2013 were sent to all Swedish primary health care centres (PHCCs) during the following year. In total, 684 (74.3%) PHCCs responded in 2006 and 880 (76.4%) in 2013.


      Compared with 2006, the median list size had decreased in 2013 (p < 0.001), whereas the median number of listed patients with T2DM had increased (p < 0.001). Time devoted to patients with T2DM and diabetes-specific education levels for registered nurses (RNs) had increased, and more PHCCs had in-house psychologists (all p < 0.001). The use of follow-up systems and medical check-ups had increased (all p < 0.05). Individual counselling was more often based on patients’ needs, while arrangement of group-based education remained low. Patient participation in setting treatment targets mainly remained low.


      Even though the diabetes-specific educational level among RNs increased, the arrangement of group-based education and patient participation in setting treatment targets remained low. These results are of concern and should be prioritised as key features in the care of patients with T2DM.


      ECTS (European Credit Transfer and Accumulation System), GP (general practitioner), NDR (National Diabetes Register), PHC (primary health care), PHCC (primary health care centre), RN (registered nurse), Swed-QOP (The Swedish National Survey of the Quality and Organisation of Diabetes Care in Primary Healthcare), T2DM (type 2 diabetes mellitus), WC (waist circumference), WTE (whole time equivalent)


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