Figure 2.

Comparison of mean HbA1c every three to four years before and after the start of Project 8 and the Uonuma School for Community Health and Social Care. The X-axis denotes the stage duration (three to four years); the Y-axis denotes HbA1c (%, NGSP). Mean HbA1c every three to four years during 2005–2020 were compared. Stage B, from 2005 to 2007, indicates a period without IPCP. Stage A1, from 2008 to 2010, designates the period of IPCP within the hospital, as well as IPCP between a clinic and a hospital, aiming for HbA1c of less than 8.0%. Stage A2, from 2011 to 2013, shows the period of IPCP within the hospital, and between a clinic and a hospital, and community-resident participation, following commencement of the Uonuma School. Stage A3, from 2014 to 2016, refers to the period when staff became cognizant of the hospital’s specialisation in the management of chronic illnesses in primary care after the reorganisation of hospitals in the Uonuma area in 2015. Stage A4, from 2017 to 2020, is the period when guidelines for diabetes mellitus published in 2017 allowed for the maintenance of slightly higher HbA1c in older adults.

A one-way ANOVA test, post hoc test, and t-test with Bonferroni correction were applied to compare all of the integrated criteria. Statistical significance was set as p < 0.05 and p < 0.01. R version 3.6.2 (The R Foundation for Statistical Computing, Austria) was used for all statistical analyses.