ArticleBMC health services research2016
Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study.
Article in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Development of a comprehensive real-world evidence dataset to inform diabetes policy: the diabetes data cell project.BMC public health · 2026Article
- A retrospective cohort study of a community-based primary care program's effects on pharmacotherapy quality in low-income Peruvians with type 2 diabetes and hypertension.PLOS global public health · 2024Article
- Development and operationalization of a data framework to assess quality of integrated diabetes care in the fragmented data landscape of Belgium.BMC health services research · 2022Article
- Making Use of Comparable Health Data to Improve Quality of Care and Outcomes in Diabetes: The EUBIROD Review of Diabetes Registries and Data Sources in Europe.Frontiers in clinical diabetes and healthcare · 2021Review
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAssessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician's actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM.
methodsData was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated.
resultsBased on the TM, 60-70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres ('poor', 'good' or 'excellent' performer) for 5-10 % of the centres.
conclusionsJudging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care.
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