Hdl Handle:
http://hdl.handle.net/10675.2/621797
Title:
Evaluation of trends in diabetes care in a patient-centered medical home
Authors:
Saucier, Ashley N; McMechan, Danielle; Dahl-Smith, Julie; Duffie, Carla; Hodo, Denise; Andrews, Holly E; Hobbs, Joseph
Abstract:
Background: The patient-centered medical home (PCMH) is a model used in primary care to achieve effective management of chronic diseases. The Augusta University Health Family Medicine Center (AUFMC), a PCMH recognized by the National Committee for Quality Assurance, has implemented strategies to manage its patient population with diabetes. The present study evaluated the effects of these interventions through trend analysis of selected diabetic core measures by use of a qualified clinical data registry, the Practice Partner Research Network. Methods: For this retrospective study, de-identified data were abstracted for adult patients with diabetes for the period of 2013-2015. Process and outcome measures were determined for selected diabetic core measures, based on the 2015 American Diabetes Association and Physician Quality Reporting System of the Centers for Medicaid and Medicare (CMS). These measures included glycated hemoglobin (HbA1c), blood pressure (BP), low-density lipoprotein cholesterol (LDL), urine microalbumin (Um), diabetic foot and eye exams, and influenza and pneumococcal vaccinations. These values were analyzed by the Cochran-Armitage test for trends over time to determine the proportions of patients at the recommended goals. Results: Over time, there were increasing trends for patients who were at the goals for frequencies of HbA1c, Um, LDL, pneumococcal vaccinations, and diabetic retinal exams (p<0.01). Increasing trends were also evident for patients at goal values for HbA1c, BP, and LDL levels (p<0.01). Decreasing trends were noted, however, in the rate of diabetic foot exams (p<0.01). Conclusions: Since AUFMC achieved PCMH recognition status, efforts to improve the management of patients with diabetes have yielded positive outcomes and valuable lessons. Areas of strength include utilization of the diabetes registry, education by regular providers, tailored use of electronic health records for patient education and physician documentation, and appropriate utilization of all team members. Trend analysis indicated that targeted diabetic interventions contributed to improved outcomes in selected diabetic core measures.
Affiliation:
Augusta University
Publisher:
Georgia Public Health Association
Journal:
Journal of the Georgia Public Health Association
Issue Date:
2017
URI:
http://hdl.handle.net/10675.2/621797
Type:
Article
Language:
en
Appears in Collections:
jGPHA Volume 6, Number 4 (2016)

Full metadata record

DC FieldValue Language
dc.contributor.authorSaucier, Ashley Nen
dc.contributor.authorMcMechan, Danielleen
dc.contributor.authorDahl-Smith, Julieen
dc.contributor.authorDuffie, Carlaen
dc.contributor.authorHodo, Deniseen
dc.contributor.authorAndrews, Holly Een
dc.contributor.authorHobbs, Josephen
dc.date.accessioned2018-04-09T00:59:06Z-
dc.date.available2018-04-09T00:59:06Z-
dc.date.issued2017-
dc.identifier.urihttp://hdl.handle.net/10675.2/621797-
dc.description.abstractBackground: The patient-centered medical home (PCMH) is a model used in primary care to achieve effective management of chronic diseases. The Augusta University Health Family Medicine Center (AUFMC), a PCMH recognized by the National Committee for Quality Assurance, has implemented strategies to manage its patient population with diabetes. The present study evaluated the effects of these interventions through trend analysis of selected diabetic core measures by use of a qualified clinical data registry, the Practice Partner Research Network. Methods: For this retrospective study, de-identified data were abstracted for adult patients with diabetes for the period of 2013-2015. Process and outcome measures were determined for selected diabetic core measures, based on the 2015 American Diabetes Association and Physician Quality Reporting System of the Centers for Medicaid and Medicare (CMS). These measures included glycated hemoglobin (HbA1c), blood pressure (BP), low-density lipoprotein cholesterol (LDL), urine microalbumin (Um), diabetic foot and eye exams, and influenza and pneumococcal vaccinations. These values were analyzed by the Cochran-Armitage test for trends over time to determine the proportions of patients at the recommended goals. Results: Over time, there were increasing trends for patients who were at the goals for frequencies of HbA1c, Um, LDL, pneumococcal vaccinations, and diabetic retinal exams (p<0.01). Increasing trends were also evident for patients at goal values for HbA1c, BP, and LDL levels (p<0.01). Decreasing trends were noted, however, in the rate of diabetic foot exams (p<0.01). Conclusions: Since AUFMC achieved PCMH recognition status, efforts to improve the management of patients with diabetes have yielded positive outcomes and valuable lessons. Areas of strength include utilization of the diabetes registry, education by regular providers, tailored use of electronic health records for patient education and physician documentation, and appropriate utilization of all team members. Trend analysis indicated that targeted diabetic interventions contributed to improved outcomes in selected diabetic core measures.en
dc.language.isoenen
dc.publisherGeorgia Public Health Associationen
dc.subjectPaitent-Centered Careen
dc.subjectMedical Homeen
dc.subjectDiabetesen
dc.subjectPrimary Health Careen
dc.titleEvaluation of trends in diabetes care in a patient-centered medical homeen
dc.typeArticleen
dc.contributor.departmentAugusta Universityen
dc.identifier.journalJournal of the Georgia Public Health Associationen
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