BACKGROUND: Despite many quality improvement trials, diabetes care often remains suboptimal. Few studies in a primary care setting have investigated the 'real life' association between organizational differences and quality of diabetes care. METHODS: Observational study among ten health care centres with a total of 45 general practitioners (GP). We investigated health care organization and related this to quality of care in a total of 1849 electronic patient records. RESULTS: There were large differences among health care centres in the percentage of patients receiving optimal care (range: 8-67%). The odds to receive good quality of care was higher if the health care centre had a diabetes education program (OR: 4.3; CI: 3.4-5.4), when yearly medical check-ups were done by both the GP and nurse practitioner (NP) (OR: 5.5; CI: 4.2-7.3), planned that after the patient visited the NP the patient is discussed with the GP (OR: 1.8; CI: 1.6-2.0), and had structured follow-up measures for compliance to check-ups (OR: 0.7; CI: 0.5-0.9 and OR: 0.59; CI: 0.5-0.7 for respectively one and two active measures compared to three active measures). CONCLUSION: Also in real life, quality of care for type 2 diabetic patients is related to health care organization.
BACKGROUND: Despite many quality improvement trials, diabetes care often remains suboptimal. Few studies in a primary care setting have investigated the 'real life' association between organizational differences and quality of diabetes care. METHODS: Observational study among ten health care centres with a total of 45 general practitioners (GP). We investigated health care organization and related this to quality of care in a total of 1849 electronic patient records. RESULTS: There were large differences among health care centres in the percentage of patients receiving optimal care (range: 8-67%). The odds to receive good quality of care was higher if the health care centre had a diabetes education program (OR: 4.3; CI: 3.4-5.4), when yearly medical check-ups were done by both the GP and nurse practitioner (NP) (OR: 5.5; CI: 4.2-7.3), planned that after the patient visited the NP the patient is discussed with the GP (OR: 1.8; CI: 1.6-2.0), and had structured follow-up measures for compliance to check-ups (OR: 0.7; CI: 0.5-0.9 and OR: 0.59; CI: 0.5-0.7 for respectively one and two active measures compared to three active measures). CONCLUSION: Also in real life, quality of care for type 2 diabeticpatients is related to health care organization.
Authors: Christel E van Dijk; Robert A Verheij; Johan Hansen; Lud van der Velden; Giel Nijpels; Peter P Groenewegen; Dinny H de Bakker Journal: BMC Health Serv Res Date: 2010-08-06 Impact factor: 2.655
Authors: Andrea S Fokkens; P Auke Wiegersma; Klaas van der Meer; Sijmen A Reijneveld Journal: BMC Health Serv Res Date: 2011-05-23 Impact factor: 2.655
Authors: Marije A van Melle; Majda Lamkaddem; Martijn M Stuiver; Annette A M Gerritsen; Walter L J M Devillé; Marie-Louise Essink-Bot Journal: BMC Fam Pract Date: 2014-09-23 Impact factor: 2.497