ArticleClinical cardiology2017
Facility-level variation in diabetes and blood pressure control in patients with diabetes: Findings from the Veterans Affairs national database.
Article in Clinical cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Characteristics of Veterans with CKD Using a Telenephrology Program in the Veterans Health Administration.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Assessment of Blood Pressure Control Among Hypertensive Patients Attending Primary Healthcare Settings in Qatar: A Retrospective Chart Review.Vascular health and risk management · 2026Article
- Relationship between health system quality and racial and ethnic equity in diabetes care.Health affairs scholar · 2024Article
- Diabetes Care Network: A Novel Model to Disseminate Team-Based Diabetes Specialty Care in a Rural Population.The science of diabetes self-management and care · 2022Article
- Article
- Facility-Level Variations in Kidney Disease Care among Veterans with Diabetes and CKD.Clinical journal of the American Society of Nephrology : CJASN · 2018Article
- Facility-level variation in diabetes and blood pressure control in patients with diabetes: Findings from the Veterans Affairs national database.Clinical cardiology · 2017Article
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Funding
Abstract
backgroundIntensive glycemic and blood pressure (BP) control in diabetic patients is associated with improved cardiovascular outcomes. HYPOTHESIS: We hypothesized that there is suboptimal glycemic and BP control with significant facility-level variation in patients with diabetes.
methodsWe identified patients with diabetes receiving care in 130 facilities in the Veterans Affairs Health Care System. We assessed facility-level rates of glycemic (hemoglobin [Hb]A1c <7%), BP (BP <140/90 mmHg), and combined glycemic and BP control (HbA1c <7% and BP <140/90 mmHg), and their facility-level variation in using median rate ratios (MRR).
resultsAmong 1 103 302 patients with diabetes, 50.2% participants had an HbA1c <7%, 77.5% had a BP <140/90 mmHg, and 39.8% had both, HbA1c <7% and BP <140/90 mmHg. Median facility-level rates were 50.3% (interquartile range [IQR], 47.9%-52.4%) for glycemic control, 78.4% (IQR, 75.2%-80.0%) for BP control, and 39.9% (IQR, 38.14%-42.34%) for combined glycemic and BP control. Unadjusted MRR for glycemic control was 1.61 (95% confidence interval [CI]: 1.51-1.70) which decreased to 1.16 (95% CI: 1.14-1.19) after adjusting for patient and facility-level variables, indicating a 16% variation in glycemic control between 2 identical patients receiving care at 2 random facilities. Unadjusted MRR for BP control was 1.49 (95% CI: 1.41-1.56), which decreased to 1.25 (95% CI: 1.21-1.28), whereas unadjusted MRR for combined glycemic and BP control was 1.59 (95% CI: 1.50-1.68), which decreased to 1.15 (95% CI: 1.13-1.17) after adjustment.
conclusionsFacility-level rates for BP control and glycemic control remain low with significant facility-level variation. Much of this is explained by patient and facility-level variables although 16%, 25%, and 15% variation in glycemic, BP, and combined glycemic and BP control remains unexplained.
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