Healthcare quality improvement programme improves monitoring of people with diabetes*1

Abstract

Does a healthcare quality improvement programme, incorporating education and claims-based feedback about practice-specific models of monitoring diabetes care, increase the regularity with which primary care physicians assess people with diabetes mellitus receiving Medicare benefits? Cluster randomised controlled trial. 22, 971 Medicare recipients with diabetes who could be linked with one of 477 study physicians in 123 non-urban counties were identified. The health care quality improvement programme significantly improved monitoring of circulating glycosylated haemoglobin (HbA1c) levels in people with diabetes compared with a no-intervention comparison group (see Table 1). There was no significant difference in number of eye exams or monitoring of urine protein levels between groups.Table 1 Proportion of people tested with quality indicators at baseline and follow-up.Quality indicator testHealth care quality improvement programmeComparison GroupDifference in change from baseline between intervention and control groups (95% CI)Proportion of people tested at baseline (%)Proportion of people tested at follow up (%)Change from baseline to follow upProportion of people tested at baseline (%)Proportion of people tested at follow up (%)Change from baseline to follow upHbA1c34.351.116.837.250.213.04.0 (0.7 to 7.3)Eye exams38.939.40.539.339.50.21.0 (-1.1 to 3.1)Quantitative urine protein2.84.61.82.74.41.70.1 (-2.1 to 3.0) The population-based health care quality improvement programme, incorporating education and claims-based feedback about practice-specific models of monitoring diabetes care, improved care of people with diabetes.