HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ackermann, R. T. Articles by Narayan, K.M. V. Search for Related Content PubMed PubMed Citation Articles by Ackermann, R. T. Articles by Narayan, K.M. V. Social Bookmarking                What's this?

Is the Number of Documented Diabetes Process-of-Care Indicators Associated With Cardiometabolic Risk Factor Levels, Patient Satisfaction, or Self-Rated Quality of Diabetes Care?

The Translating Research into Action for Diabetes (TRIAD) study

¹ Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
² Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
³ Division of Research, Kaiser Permanente, Oakland, California
⁴ Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama
⁵ Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California

Address correspondence and reprint requests to Ronald T. Ackermann, MD, MPH, 250 University Blvd., Suite 122, Indianapolis, IN 46202. E-mail: rtackerm{at}iupui.edu

OBJECTIVE—Simple process-of-care indicators are commonly recommended to assess and compare quality of diabetes care across health plans. We sought to determine whether variation in the number of simple diabetes processes of care across provider groups is associated with variation in other quality indicators, including cardiometabolic risk factor levels, patient satisfaction with care, or patient-rated quality of care.

RESEARCH DESIGN AND METHODS—We used cross-sectional survey and chart audit data for 8,733 patients with diabetes who received care from 68 provider groups nested in 10 health plans that participated in the Translating Research Into Action for Diabetes study. Analyses using hierarchical regression models assessed associations of the mean number of seven simple process measures with each of the following: HbA_1c (A1C), systolic blood pressure (SBP), HDL and LDL cholesterol levels, patient satisfaction with care, and patient-rated quality of care.

RESULTS—After adjusting for case-mix differences across groups and plans, an average of one additional documented process of care for each patient in a group or plan was associated with significantly lower mean LDL cholesterol levels (–4.51 mg/dl [95% CI 1.46–7.58]) but not with A1C, SBP, or HDL cholesterol levels. The number of care processes documented was associated with patient satisfaction measures and self-rated quality of diabetes care.

CONCLUSIONS—Variation in the number of simple process-of-care indicators across provider groups or health plans is associated with differences in patient-centered measures of quality, but assessment of the quality of cardiometabolic risk factor control will require more advanced clinical performance indicators.

Abbreviations: CAHPS, Consumer Assessment of Health Plans Survey • CHD, coronary heart disease • CHS, courteous and helpful staff • DQIP, Diabetes Quality Improvement Project • GNC, getting needed care • HDC, how doctors communicate • SBP, systolic blood pressure • TRIAD, Translating Research into Action for Diabetes • UKPDS, UK Prospective Diabetes Study

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				K. A. Hahn, J. M. Ferrante, J. C. Crosson, S. V. Hudson, and B. F. Crabtree Diabetes Flow Sheet Use Associated With Guideline Adherence Ann. Fam. Med, May 1, 2008; 6(3): 235 - 238. [Abstract] [Full Text] [PDF]

				M. L. Parchman, J. A. Pugh, C.-P. Wang, and R. L. Romero Glucose Control, Self-Care Behaviors, and the Presence of the Chronic Care Model in Primary Care Clinics Diabetes Care, November 1, 2007; 30(11): 2849 - 2854. [Abstract] [Full Text] [PDF]

				M. D. Sadof, S. Rosenbaum, M. T. Smolkin, J. V. Selby, C. M. Mangione, R. B. Gerzoff, B. E. Landon, L. S. Hicks, and E. Guadagnoli Improving the Management of Chronic Disease N. Engl. J. Med., June 7, 2007; 356(23): 2422 - 2424. [Full Text] [PDF]

				J. Voorham, P. Denig, and Groningen Initiative to Analyse Type 2 Diabetes Tr Computerized Extraction of Information on the Quality of Diabetes Care from Free Text in Electronic Patient Records of General Practitioners J. Am. Med. Inform. Assoc., May 1, 2007; 14(3): 349 - 354. [Abstract] [Full Text] [PDF]