(Journal Article): Adherence to Guidelines and its Effects on Hospitalizations with Complications of Type 2 Diabetes
Sloan FA, Bethel MA, Lee PP, Brown DS, Feinglos MN (Center for Health Policy, Law, and Management and Department of Economics, Box 90253, Duke,
fsloan(at)hpolicy.duke.edu
)
IN:
Rev Diabetic Stud
2004; 1(1):29-38
Impact Factor(s) of Rev Diabetic Stud: 0.125 (2006)
ABSTRACT: OBJECTIVES: To study the discrepancy between actual and recommended rates of use among several measures of screening for complications of diabetes in a national longitudinal sample, the correlations among measures of adherence, and whether or not higher rates of adherence reduce hospitalizations for complications of diabetes. The key study hypothesis was that lack of adherence to professional recommendations for diabetes care leads to adverse health outcomes for elderly persons. METHODS: Administrative claims and survey data for 1994-1999 on a nationally representative sample of Medicare beneficiaries age 65+. Principal components analysis and instrumental variables probit regression methods were used. RESULTS: Most Medicare beneficiaries diagnosed with type 2 diabetes had at least one physician visit per year, but rates of screening (eye examinations and HbA1c, lipid, microalbumin and urine tests) fell far short of recommendations. Correlations among use rates for various types of screening were positive but far less than one, suggesting that failure to screen reflects a complex set of underlying factors. Increased rates of adherence were observed for HbA1c and lipid testing over the observation period. Higher use was associated with lower rates of hospitalization for complications of diabetes (vascular (p=0.007), renal (p=0.002), and other complication (p=0.005)). CONCLUSIONS: Adherence to guidelines was associated with significantly reduced rates of hospitalization. Continued analysis of the trends in clinical practice is needed to demonstrate the effectiveness of standardized guidelines for the care of patients with diabetes.
TYPE OF PUBLICATION: Original article
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(Journal Article): Physician Process and Patient Outcome Measures for Diabetes Care: Relationships to Organizational Characteristics
Ward MM, Yankey JW, Vaughn TE, BootsMiller BJ, Flach SD, Welke KF, Pendergast JF, Perlin J, Doebbeling BN (Department of Health Management and Policy, University of Iowa, Iowa City, Iowa; daggerIowa City Veterans Affairs Medical Center, Iowa City, Iowa; double daggerDepartment of Internal Medicine, University of Iowa, Iowa City, Iowa; section signDivision of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa; paragraph signDepartment of Biostatistics, University of Iowa, Iowa City, Iowa; parallelOffice of Quality and Performance, Veterans Health Administration, Washington DC, USA)
IN:
Med Care
2004; 42(9):840-850
Impact Factor(s) of Med Care: 2.907 (2004), 3.152 (2003), 3.228 (2002), 2.552 (2001)
ABSTRACT: BACKGROUND:: Optimal diabetes management relies on providers adhering to evidence-based practice guidelines in the processes of care delivery and patients adhering to self-management recommendations to maximize patient outcomes. PURPOSE:: To explore: (1) the degree to which providers adhere to the guidelines; (2) the extent of glycemic, lipid, and blood pressure control in patients with diabetes; and (3) the roles of organizational and patient population characteristics in affecting both provider adherence and patient outcome measures for diabetes. DESIGN:: Secondary data analysis of provider adherence and patient outcome measures from chart reviews, along with surveys of facility quality managers. SAMPLE:: We sampled 109 Veterans Affairs medical centers (VAMCs). RESULTS:: Analyses indicated that provider adherence to diabetes guidelines (ie, hemoglobin A1c, foot, eye, renal, and lipid screens) and patient outcome measures (ie, glycemic, lipid, and hypertension control plus nonsmoking status) are comparable or better in VAMCs than reported elsewhere. VAMCs with higher levels of provider adherence to diabetes guidelines had distinguishing organizational characteristics, including more frequent feedback on diabetes quality of care, designation of a guideline champion, timely implementation of quality-of-care changes, and greater acceptance of guideline applicability. VAMCs with better patient outcome measures for diabetes had more effective communication between physicians and nurses, used educational programs and Grand Rounds presentations to implement the diabetes guidelines, and had an overall patient population that was older and with a smaller percentage of black patients. CONCLUSIONS:: Healthcare organizations can adopt many of the identified organizational characteristics to enhance the delivery of care in their settings.
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(Journal Article): The Influence of Physicians' Practice Management Strategies and Financial Arrangements on Quality of Care Among Patients With Diabetes
Keating NL, Landrum MB, Landon BE, Ayanian JZ, Borbas C, Wolf R, Guadagnoli E (Department of Health Care Policy, Harvard Medical School; daggerthe Division of General Internal Medicine, Brigham and Women's Hospital; and double daggerthe Division of General Internal Medicine, Beth Israel Deaconess Hospital, Boston, Massachusetts; and the section signHealthcare Evaluation and Research Foundation, St. Paul, Minnesota, USA)
IN:
Med Care
2004; 42(9):829-839
Impact Factor(s) of Med Care: 2.907 (2004), 3.152 (2003), 3.228 (2002), 2.552 (2001)
Fulltext: HTML
ABSTRACT: CONTEXT:: Health care organizations use many strategies to influence physician behavior and the care delivered, but the effect of such strategies on quality is not known. OBJECTIVE:: We sought to assess the influence of practice management strategies and financial arrangements on the quality of diabetes care. DESIGN:: This was a retrospective cohort study including medical record reviews and a physician survey. PARTICIPANTS:: Patients with diabetes mellitus (n = 652) enrolled in 3 health plans located in Minnesota and 399 physicians in 135 practices who cared for them participated in this study. MAIN OUTCOME MEASURE:: Our main outcome measures was a quality score indicating receipt of care in accordance with 6 accepted quality indicators. RESULTS:: The mean quality score was 2.4 (SD 1.2) on a 6-point scale. Only a small proportion of the variation in quality was attributed to characteristics of physicians' practices (5%). Quality scores tended to be higher for patients whose physicians received quality performance reports or utilization profiles from more than 1 source (P = 0.08), routinely enrolled diabetic patients in disease-management programs (P = 0.06), or received diabetes-specific reports (P = 0.06). Quality scores were lower for patients whose physicians were paid according to fee-for-service compared with salary (P = 0.04) and served as gatekeepers for >50% of their patients (P = 0.06). However, these findings were all of borderline statistical significance, and the absolute differences in quality were small. CONCLUSIONS:: Current practice management strategies and financial arrangements have a limited impact on the quality of care for patients with diabetes. These findings suggest that other strategies may be necessary for health care organizations to improve care for patients with diabetes.
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(Journal Article): Recommendations from the Canadian Diabetes Association. 2003 guidelines for prevention and management of diabetes and related cardiovascular risk factors
Harris SB, Lank CN (Department of Family Medicine, University of Western Ontario, London, USA)
IN:
Can Fam Physician
2004; 50:425-433
Impact Factor(s) of Can Fam Physician: 0.402 (2004), 0.365 (2003), 0.348 (2001)
ABSTRACT: Not available.
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(Journal Article): Effectiveness of a disease management program for patients with diabetes
Villagra VG, Ahmed T (Health and Technology Vector Inc., Farmington, Connecticut, USA,
victor.villagra@snet.net
)
IN:
Health Aff (Millwood)
2004; 23(4):255-266
Impact Factor(s) of Health Aff (Millwood): 3.369 (2004), 3.673 (2003), 3.363 (2001)
ABSTRACT: Diabetes disease management programs (DDMPs) are proliferating, but their effectiveness in improving quality and mitigating health care spending has been difficult to measure. Using two quasi-experimental methods, this study analyzed the first-year results of a multistate DDMP for people with diabetes sponsored by a national managed care organization. In both analyses, overall cost of care were significantly lower in DDMP sites, and the payer saved more than it spent. Pharmacy costs showed mixed results. Quality scores in the DDMP sites were significantly better than in sites without the program.
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(Journal Article): Time to get motivated. Sometimes diabetes care can be a drag. Here's how to renew, refresh, and reinvigorate your commitment to better diabetes management
Earles J
IN:
Diabetes Forecast
2003; 56(12):50-53
ABSTRACT: Not available.
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(Journal Article): The performance of the screener to identify children with special health care needs in a European sample of children with chronic conditions
Schmidt S, Thyen U, Petersen C, Bullinger M (Institute and Clinic of Medical Psychology, Centre for Psychosocial Medicine S35, University Hospital of Hamburg Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany,
sischmid@uke.uni-hamburg.de
)
IN:
Eur J Pediatr
2004; 163(9):517-523
Impact Factor(s) of Eur J Pediatr: 1.369 (2004), 1.157 (2003), 1.223 (2002), 1.22 (2001)
ABSTRACT: In the field of paediatric health care, measures based on consequences of health conditions have been recently developed to screen for children with special health care needs. These tools have been primarily used in survey research. The aim of this cross-sectional clinical study is to test the performance of a screener for identifying children with special health care needs (CSHCN) in a population of children with chronic conditions diagnosed and treated in different European paediatric hospitals. In the current study, the screener was employed in a sample of children with different chronic conditions (asthma, arthritis, dermatitis, epilepsy, cystic fibrosis, diabetes and cerebral palsy) across seven European countries; 456 parents of children, aged 4-7, 8-12, and 13-16 years, responded to the screener items. The study included a range of clinical measures to assess the severity of the conditions as well measures on functional health status. The prevalence of children identified positively with the CSHCN screener was 80%, which was higher than in survey estimates in the United States. Considerable variation in the screener classification was found between chronic conditions with cystic fibrosis and epilepsy showing higher rates, and skin conditions lower rates. There was no significant relationship between the screener classification and functional limitation. Findings of this study support in general the validity of the children with special health care needs screener, which shows, however, a differential validity across specific conditions. Several clinical and theoretical explanations for the lack of identifying some children with chronic conditions and the considerable variation between the conditions are discussed.
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(Journal Article): Diabetes 2001 Vital Statistics.
American Diabetes Association
IN:
American Diabetes Association, Alexandria, VA,
2001; American Diabetes Association, Alexandria, VA, 2001
TYPE OF PUBLICATION: Original article
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(Journal Article): Diabetes in America.
National Diabetes Data Group
IN:
National Institutes of Health, National Institute of Diabetes and Diges-tive and Kidney Diseases, Bethesda, MD.
1995, 2nd ed.; :-
TYPE OF PUBLICATION: Original article
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(Journal Article): Glycemic control in diabetes mellitus: Have changes in therapy made a difference?
Nathan DM, McKitrick C, Larkin M, Schaffran R, Singer DE
IN:
Am J Med
1996; 100(2):157-63
Impact Factor(s) of Am J Med: 4.179 (2004), 4.403 (2003), 6.106 (2001)
TYPE OF PUBLICATION: Original article
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(Journal Article): Cost-effectiveness of detecting and treating diabetic retinopathy.
Javitt JC, Aiello LP
IN:
Ann Intern Med
1996; 124(1 Pt 2):164-169
Impact Factor(s) of Ann Intern Med: 13.114 (2004), 12.427 (2003), 11.416 (2002), 11.13 (2001)
TYPE OF PUBLICATION: Original article
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(Journal Article): Estimated benefits of glycemic control in microvascular complications in type 2 diabetes.
Vijan S, Hofer TP, Hayward RA
IN:
Ann Intern Med
1997; 127(9):788-795
Impact Factor(s) of Ann Intern Med: 13.114 (2004), 12.427 (2003), 11.416 (2002), 11.13 (2001)
TYPE OF PUBLICATION: Original article
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(Journal Article): Cost-utility analysis of screening intervals for diabetic retinopathy in patients with type 2 diabetes mellitus.
Vijan S, Hofer TP, Hayward RA
IN:
JAMA
2000; 283(7):889-896
Impact Factor(s) of JAMA: 23.332 (2005), 24.831 (2004), 21.455 (2003), 17.569 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): Physician and patient prevention practices in NIDDM in a large urban managed-care organization.
Martin TL, Selby JV, Zhang D
IN:
Diabetes Care
1995; 18(8):1124-1132
Impact Factor(s) of Diabetes Care: 7.071 (2004), 7.501 (2003), 5.477 (2002), 5.404 (2001)
TYPE OF PUBLICATION: Original article
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(Journal Article): Variation in office-based quality: A claims-based profile of care provided to Medicare patients with diabetes.
Weiner JP, Parente ST, Gamick DW, Fowles J, Lawthers AG, Palmer H
IN:
JAMA
1995; 273:1503-1508
Impact Factor(s) of JAMA: 23.332 (2005), 24.831 (2004), 21.455 (2003), 17.569 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): Adherence to American Diabetes Association standards of care by rural health care providers.
Coon P, Zulkowski K
IN:
Diabetes Care
2002; 25(12):2224-2229
Impact Factor(s) of Diabetes Care: 7.071 (2004), 7.501 (2003), 5.477 (2002), 5.404 (2001)
TYPE OF PUBLICATION: Original article
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(Journal Article): Longitudinal rates of annual eye examinations of persons with diabetes and chronic eye diseases.
Lee PP, Feldman ZW, Ostermann J, Brown DS, Sloan FA
IN:
Ophthalmol
2003; 110(10):1952-1959
TYPE OF PUBLICATION: Original article
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(Journal Article): Changes in the quality of care delivered to Medicare beneficiaries, 1998-1999 to 2000-2001.
Jencks SF, Huff ED, Cuerdon T
IN:
JAMA
2003; 289(3):305-312
Impact Factor(s) of JAMA: 23.332 (2005), 24.831 (2004), 21.455 (2003), 17.569 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): The quality of health care delivered to adults in the United States.
McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA
IN:
NEJM
2003; 348(26):2635-2645
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): The role of patient, physician and systemic factors in the management of type 2 diabetes mellitus.
Brown JB, Harris SB, Webster-Bogaert S, Wetmore S, Faulds C, Stewart M
IN:
Fam Pract
2002; 19(4):344-349
Impact Factor(s) of Fam Pract: 1.296 (2004), 1.023 (2003), 1.061 (2002), 1.162 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): Why don't physicians follow clinical practice guidelines? A framework for improvement.
Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR
IN:
JAMA
1999; 282(15):1458-1465
Impact Factor(s) of JAMA: 23.332 (2005), 24.831 (2004), 21.455 (2003), 17.569 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): The patient-provider relationship: attachment theory and adherence to treatment in diabetes.
Ciechanowski PS, Katon WJ, Russo JE, Walker EA
IN:
Am J Psychiatry
2001; 158(1):29-35
Impact Factor(s) of Am J Psychiatry: 7.614 (2004), 7.157 (2003), 6.913 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): Identifying persons with diabetes using Medicare claims data.
Hebert PL, Geiss LS, Tierney EF, Engelgau MM, Yawn BP, McBean AM
IN:
Am J Med Qual
1999; 14(6):270-277
Impact Factor(s) of Am J Med Qual: 0.667 (2004), 0.472 (2003), 1.239 (2001)
TYPE OF PUBLICATION: Original article
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(Journal Article): Efficient estimation of limited dependent variable models.
Newey W
IN:
J Econom
1987; 36:231-250
Impact Factor(s) of J Econom: 1.32 (2004), 1.135 (2003), 1.106 (2002), 1.266 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): An exogeneity test for a simultaneous equation tobit model with an application to labor supply.
Smith RJ, Blundell RW
IN:
Econometrica
1986; 54(4):679-686
Impact Factor(s) of Econometrica: 2.163 (2004), 2.215 (2003), 1.923 (2001)
TYPE OF PUBLICATION: Original article
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(Journal Article): Diagnosis-based risk adjustment for Medicare capitation payments.
Ellis RP, Pope GC, Iezzoni LI, Ayanian JZ, Bate, DW, Burstin H, Ash AS
IN:
Health Care Financ Rev
1996; 17:101-128
Impact Factor(s) of Health Care Financ Rev: 0.558 (2003), 0.699 (2002), 1.085 (2001)
TYPE OF PUBLICATION: Original article
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(Journal Article): The prevalence of multiple diabetes-related complications.
Morgan CL, Currie CJ, Stott NC, Smithers M, Butler CC, Peters JR
IN:
Diabet Med
2000; 17(2):146-151
Impact Factor(s) of Diabet Med: 2.621 (2004), 2.235 (2003), 2.678 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): The effect of intensive diabetes treatment on the development and progression of long-term complications in insulin dependent diabetes mellitus: The diabetes control and com-plications trial.
The Diabetes Control and Complications Trial Research Group
IN:
NEJM
1993; 329:977-986
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): Intensive blood-glucose control with sulphonylureas or insulin compared with convention treatment and risk of complication in patients with type 2 diabetes (UKPDS 33).
United Kingdom Prospective Diabetes Study Group
IN:
Lancet
1998; 352:837-853
Impact Factor(s) of Lancet: 23.407 (2005), 21.713 (2004), 18.316 (2003), 15.397 (2002), 13.251 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
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(Journal Article): Effect of intensive blood- glucose control with metfomrin on complications in overweight patients with type 2 diabetes (UKPDS 34).
United Kingdom Prospective Diabetes Study Group
IN:
Lancet
1998; 352:854-865
Impact Factor(s) of Lancet: 23.407 (2005), 21.713 (2004), 18.316 (2003), 15.397 (2002), 13.251 (2001)
Fulltext: HTML
TYPE OF PUBLICATION: Original article
Articles citing this article:
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(Journal Article): Building a better quality measure: Are some patients with “poor quality” actually getting good care?
Kerr EA, Smith DM, Hogan MM, Hofer TP, Krein SL, Bermann M, Hayward RA
IN:
Med Care
2003; 41(10):1173-1182
Impact Factor(s) of Med Care: 2.907 (2004), 3.152 (2003), 3.228 (2002), 2.552 (2001)
TYPE OF PUBLICATION: Original article
Articles citing this article:
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(Journal Article): Model of complications of NIDDM. I. Model construction and assumptions.
Eastman RC, Javitt JC, Herman WH, Dasbach EJ, Zbrozek AS, Dong F, Manninen D, Garfield SA, Copley-Merriman C, Maier W, et al
IN:
Diabetes Care
1997; 20(5):725-734
Impact Factor(s) of Diabetes Care: 7.071 (2004), 7.501 (2003), 5.477 (2002), 5.404 (2001)
TYPE OF PUBLICATION: Original article
Articles citing this article:
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(Journal Article): Early Model of complications of NIDDM.
Eastman RC, Javitt JC, Herman WH, Dasbach EJ, Copley-Merriman C, Maier W, Dong F, Manninen D, Zbrozek AS, Kotsanos J, et al
IN:
Diabetes Care
1997; 20(5):735-744
Impact Factor(s) of Diabetes Care: 7.071 (2004), 7.501 (2003), 5.477 (2002), 5.404 (2001)
TYPE OF PUBLICATION: Original article
Articles citing this article:
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