Association Between Clinical Practice Group Adherence to Quality Measures and Adverse Outcomes Among Adult Patients With Diabetes
| Autor: | Barbara Bai, Mary Beth Landrum, Bruce E. Landon, Lauren Gilstrap, Michael E. Chernew, Sartaj Alam, Christina A. Nguyen, J. Michael McWilliams |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Cross-sectional study Disease Comorbidity Young Adult Internal medicine Diabetes mellitus medicine Humans Young adult Reimbursement Original Investigation Aged Quality Indicators Health Care Retrospective Studies Glycated Hemoglobin business.industry Research Health Policy Retrospective cohort study General Medicine Cholesterol LDL Middle Aged medicine.disease Hospitalization Online Only Cross-Sectional Studies Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 Cohort Group Practice Female Hydroxymethylglutaryl-CoA Reductase Inhibitors business |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question What are the correlations between types of quality measures in treatment of diabetes, and how might these correlations be associated with quality-based reimbursement for chronic diseases? Findings In this cross-sectional study of 652 258 adults with diabetes from 2010 to 2014 at the clinical practice group level, correlations among quality measures were weak, and process and disease control performance were not strongly associated with hospitalization rates. Process and disease control performance at the clinical practice group level explained 3.9% of the variation in hospitalization rates at the individual level. Meaning These findings raise concern about the use of utilization-based outcomes (hospitalizations) as a measure of quality in chronic diseases. This cross-sectional analysis examines the associations among clinical practice group performance on quality measures, including process measures, disease control measures, and utilization-based outcomes, among adults treated for diabetes. Importance Clinical practice group performance on quality measures associated with chronic disease management has become central to reimbursement. Therefore, it is important to determine whether commonly used process and disease control measures for chronic conditions correlate with utilization-based outcomes, as they do in acute disease. Objective To examine the associations among clinical practice group performance on diabetes quality measures, including process measures, disease control measures, and utilization-based outcomes. Design, Setting, and Participants This retrospective, cross-sectional analysis examined commercial claims data from a national health insurance plan. A cohort of eligible beneficiaries with diabetes aged 18 to 65 years who were enrolled for at least 12 months from January 1, 2010, through December 31, 2014, was defined. Eligible beneficiaries were attributed to a clinical practice group based on the plurality of their primary care or endocrinology office visits. Data were analyzed from October 1, 2018, through April 30, 2019. Main Outcomes and Measures For each clinical practice group, performance on current diabetes quality measures included 3 process measures (2 testing measures [hemoglobin A1c {HbA1c} and low-density lipoprotein {LDL} testing] and 1 drug use measure [statin use]) and 2 disease control measures (HbA1c |
| Databáze: | OpenAIRE |
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