ArticleBMC endocrine disorders2014
The association between improved quality diabetes indicators, health outcomes and costs: towards constructing a "business case" for quality of diabetes care--a time series study.
Article in BMC endocrine disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Primary care physicians' perceptions of Israel's national program for quality indicators in community healthcare- 2010 and 2020.Israel journal of health policy research · 2025Article
- Article
- Food as medicine? Exploring the impact of providing healthy foods on adherence and clinical and economic outcomes.Exploratory research in clinical and social pharmacy · 2022Article
- Improving Diabetes Control Using Lean Six Sigma Quality Improvement in an Endocrine Clinic in a Large Accountable Care Organization.Clinical diabetes : a publication of the American Diabetes Association · 2021Article
- Personalized Health Systems-Past, Present, and Future of Research Development and Implementation in Real-Life Environment.Frontiers in medicine · 2019Review
- Trends in the performance of quality indicators for diabetes care in the community and in diabetes-related health status: an Israeli ecological study.Israel journal of health policy research · 2018Article
- Association of extracellular superoxide dismutase (EC-SOD) polymorphisms with risk of type 2 diabetes mellitus in a Chinese Han population.International journal of clinical and experimental pathology · 2017Article
- Quality of care for patients with diabetes mellitus type 2 in 'model practices' in Slovenia - first results.Zdravstveno varstvo · 2016Review
- Association between occupational stressors and type 2 diabetes among Chinese police officers: a 4-year follow-up study in Tianjin, China.International archives of occupational and environmental health · 2016Article
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5 authors.
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Abstract
backgroundIn primary health care systems where member's turnover is relatively low, the question, whether investment in quality of care improvement can make a business case, or is cost effective, has not been fully answered.The objectives of this study were: (1) to investigate the relationship between improvement in selected measures of diabetes (type 2) care and patients' health outcomes; and (2) to estimate the association between improvement in performance and direct medical costs.
methodsA time series study with three quality indicators - Hemoglobin A1c (HbA1c) testing, HbA1C and LDL- cholesterol (LDL-C) control - which were analyzed in patients with diabetes, insured by a large health fund. Health outcomes measures used: hospitalization days, Emergency Department (ED) visits and mortality. Poisson, GEE and Cox regression models were employed. Covariates: age, gender and socio-economic rank.
results96,553 adult (age >18) patients with diabetes were analyzed. The performance of the study indicators, significantly and steadily improved during the study period (2003-2009). Poor HbA1C (>9%) and inappropriate LDL-C control (>100 mg/dl) were significantly associated with number of hospitalization days. ED visits did not achieve statistical significance. Improvement in HbA1C control was associated with an annual average of 2% reduction in hospitalization days, leading to substantial reduction in tertiary costs. The Hazard ratio for mortality, associated with poor HbA1C and LDL-C, control was 1.78 and 1.17, respectively.
conclusionOur study demonstrates the effect of continuous improvement in quality care indicators, on health outcomes and resource utilization, among patients with diabetes. These findings support the business case for quality, especially in healthcare systems with relatively low enrollee turnover, where providers, in the long term, could "harvest" their investments in improving quality.
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