Medical home implementation and trends in diabetes quality measures for AN/AI primary care patients
| Autor: | Janet M. Johnston, David Driscoll, Julia J. Smith, Denise A. Dillard, Vanessa Y. Hiratsuka, Steve Tierney |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Program evaluation
Medical home Gerontology Time Factors Quality management Endocrinology Diabetes and Metabolism Interrupted Time Series Analysis Patient Admission Predictive Value of Tests Patient-Centered Care Diabetes mellitus Health care Internal Medicine Humans Medicine Quality Indicators Health Care Glycated Hemoglobin Nutrition and Dietetics Primary Health Care business.industry Incidence Incidence (epidemiology) Length of Stay medicine.disease Quality Improvement United States Diabetes Mellitus Type 2 Predictive value of tests United States Indian Health Service Indians North American Health Resources Emergency Service Hospital Family Practice business Alaska Biomarkers Program Evaluation Demography |
| Zdroj: | Primary Care Diabetes. 9:120-126 |
| ISSN: | 1751-9918 |
| DOI: | 10.1016/j.pcd.2014.06.005 |
| Popis: | Patient-centered medical home (PCMH) principles including provider continuity, coordination of care, and advanced access align with healthcare needs of patients with Type II diabetes mellitus (DM-II). We investigate changes in trend for DM-II quality indicators after PCMH implementation at Southcentral Foundation, a tribal health organization in Alaska.Monthly rates of DM-II incidence, hemoglobin A1c (HbA1c) measurements, and service utilization were calculated from electronic health records from 1996 to 2009. We performed interrupted time series analysis to estimate changes in trend.Rates of new DM-II diagnoses were stable prior to (p=0.349) and increased after implementation (p0.001). DM-II rates of HbA1c screening increased, though not significantly, before (p=0.058) and remained stable after implementation (p=0.969). There was non-significant increasing trend in both periods for percent with average HbA1c less than 7% (53 mmol/mol; p=0.154 and p=0.687, respectively). Number of emergency visits increased before (p0.001) and decreased after implementation (p0.001). Number of inpatient days decreased in both periods, but not significantly (p=0.058 and p=0.101, respectively).We found positive changes in DM-II quality trends following PCMH implementation of varying strength and onset of change, as well as duration of sustained trend. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect