Care Management Processes Important for High-Quality Diabetes Care
Authors' conclusion
Effective quality improvement in primary care focuses on practice redesign that clearly improves diabetes outcomes. Tailoring CMP adoption in primary care provides effective improvement in ODC performance through focused changes in diabetes outcomes.
Study context
- Population
- All diabetes patients seen in a cohort of 330 primary care practices in 2017 and 2019330 primary care practices
- Exposure
- Implementation of care management processes vs non-implementation
- Outcome
- Five outcomes: A1c, systolic and diastolic BP, guideline-based statin use, and Optimal Diabetes Care (ODC)
Methodological detailsBayesian five-outcome model, patient-year unit of analysis with practice-level care management processes (CMP) exposures, controlled for unobserved time-invariant practice characteristics and secular change
- Bayesian five-outcome model
- Patient-year unit of analysis with practice-level CMP exposures
- Controlled for unobserved time-invariant practice characteristics and secular change
Main finding
As reported in the abstract
CMPs associated with statistically significant improvements in patient outcomes
18 of 62
More patients meeting Optimal Diabetes Care (ODC) performance measures, all significant CMPs together
12.1%
Observational data: associations, not effects.
Further findings
Contribution of 3 CMPs (patient identification/reminder systems for testing; after-visit nonclinician follow-up; guideline-based clinician reminders for preventive services during visit)
- Share of total ODC improvement
- 47%
- Share of A1c decrease
- 68%
- Share of SBP reduction
- 21%
- Share of statin use increase
- 55%
Original publication
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