Quality of diabetes care at a Ghanaian Teaching Hospital (2022-2023): Retrospective chart review benchmarking against American Diabetes Association (ADA) Standards.

Background: Diabetes mellitus is a global major health concern, with increasing prevalence in Ghana, causing significant mortality and morbidity. Effective management of this chronic condition depends on resilient healthcare systems that adhere to evidence-based guidelines. This study aimed to evaluate the quality-of-care at the diabetic clinic of the Cape Coast Teaching Hospital (CCTH) using the American Diabetes Association (ADA) guidelines as the benchmarks to show the performance of the hospital clearly, reveal gaps in the management algorithm that need to be addressed, and to contribute to the body of knowledge in the health sector of our country. Methods: Retrospective chart review was done from January 2022 to March 2023. 261 patient records were used out of a total study population of 780. Primary process indicators (medical history, physical examination, laboratory check-ups, referrals) and outcome indicators (HbA1c<7%, BP<140/90 mmHg, lipid profile, liver function test, kidney function based on eGFR categories). In analyzing the data, the Statistical Package for Social Sciences (SPSS version 21) software and STATA vs.14 were used to generate frequencies, means, and percentages presented in tables, charts, and graphs to provide answers to the research questions. Results: The overall documented adherence rates were: medical history (17%), physical examination (58.4%), laboratory evaluation (24%), and referrals (5%). These were coupled with low rates of achievement of treatment targets for various clinical outcomes, specifically glycated hemoglobin (HbA1c), blood pressure, lipid profile and estimated glomerular filtration rate (eGFR), with corresponding percentages of 47.2%, 42%, 47.1%, and 48.8%, respectively. Conclusion: The study, therefore, revealed gaps in compliance and documentation, which should be addressed to improve clinical care and patient outcomes.