ArticleBJGP open2020
The effect of 'paying for performance' on the management of type 2 diabetes mellitus: a cross-sectional observational study.
Article in BJGP open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Development of diabetes complications within coordinated and structured primary health care: a 10-year retrospective cohort study in Germany.BJGP open · 2024Article
- Determinants of poor glycaemic control and proteinuria in patients with type 2 diabetes: a retrospective analysis of general practice records in Ireland.BMC primary care · 2024Article
- Strategies to tackle non-communicable diseases in Afghanistan: A scoping review.Frontiers in public health · 2023Article
- A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland.BMC public health · 2020Article
- Blood pressure control in patients with a previous stroke/transient ischaemic attack in primary care in Ireland: a cross sectional study.BMC family practice · 2020Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 'cycle of care' (COC) pay for performance (PFP) programme, introduced in 2015, has resourced Irish GPs to provide structured care to PCRS eligible patients with type 2 diabetes mellitus (T2DM).
aimTo investigate the effect of COC on management processes. DESIGN &
settingCross-sectional observational study undertaken with two points of comparison (2014 and 2017) in participating practices (Republic of Ireland general practices), with comparator data from the United Kingdom National Diabetes Audit (UKNDA) 2015-2016.
methodInvitations to participate were sent to practices using a discussion forum for Health One clinical software. Participating practices provided data on the processes of care in the management of patients with T2DM. Data on PCRS eligible patients was extracted from the electronic medical record system of participating practices using secure customised software. Descriptive analysis, using IBM SPSS Statistics for Windows (version 25), was performed.
resultsOf 250 practices invited, 41 practices participated (16.4%), yielding data from 3146 patients. There were substantial improvements in the rates of recording of glycosylated haemoglobin ([HbA1c] 53.1%-98.3%), total cholesterol ([TC] 59.2%-98.8%), urinary albumin:creatinine ratio ([ACR] 9.9%-42.3%), blood pressure ([BP] 61.4%-98.2%), and body-mass index ([BMI] 39.8%-97.4%) from 2014 to 2017. For the first time, rates of retinopathy screening (76.3%), foot review (64.9%), and influenza immunisation (69.9%) were recorded. Comparison of 2017 data with UKNDA 2015-2016 was broadly similar.
conclusionThe COC demonstrated much improved rates of recording of clinical and biochemical parameters, and improved achievement of targets in TC and BP, but not HbA1c. Results demonstrate substantial improvements in the processes and quality of care in the management of patients with T2DM.
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