Ignacio Ricci-Cabello1, Sarah Stevens2, Evangelos Kontopantelis3, Andrew R H Dalton2, Robert I Griffiths2, John L Campbell4, Tim Doran5, Jose M Valderas6. 1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom ignacio.riccicabello@phc.ox.ac.uk. 2. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom. 3. National Institute for Health Research (NIHR) School for Primary Care Research, Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, United Kingdom Centre for Health Informatics, Institute of Population Health, University of Manchester, Manchester, United Kingdom. 4. APEx Collaboration for Academic Primary Care, Institute for Health Services Research, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom. 5. Department of Health Sciences, University of York, York, United Kingdom. 6. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom APEx Collaboration for Academic Primary Care, Institute for Health Services Research, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom.
Abstract
PURPOSE: The purpose of this study was to examine the association between the prevalence of both diabetes-concordant and diabetes-discordant conditions and the quality of diabetes care at the family practice level in England. We hypothesized that the prevalence of concordant (or discordant) conditions would be associated with better (or worse) quality of diabetes care. METHODS: We conducted a cross-sectional study using practice-level data (7,884 practices). We estimated the practice-level prevalence of diabetes and 15 other chronic conditions, which were classified as diabetes concordant (ie, with the same pathophysiologic risk profile and therefore more likely to be part of the same management plan) or diabetes discordant (ie, not directly related in either their pathogenesis or management). We measured quality of diabetes care with diabetes-specific indicators (8 processes and 3 intermediate outcomes of care). We used linear regression models to quantify the effect of the prevalence of the conditions on aggregate achievement rate for quality of diabetes care. RESULTS: Consistent with the proposed model, the prevalence rates of 4 of 7 concordant conditions (obesity, chronic kidney disease, atrial fibrillation, heart failure) were positively associated with quality of diabetes care. Similarly, negative associations were observed as predicted for 2 of the 8 discordant conditions (epilepsy, mental health). Observations for other concordant and discordant conditions did not match predictions in the hypothesized model. CONCLUSIONS: The quality of diabetes care provided in English family practices is associated with the prevalence of other major chronic conditions at the practice level. The nature and direction of the observed associations cannot be fully explained by the concordant-discordant model.
PURPOSE: The purpose of this study was to examine the association between the prevalence of both diabetes-concordant and diabetes-discordant conditions and the quality of diabetes care at the family practice level in England. We hypothesized that the prevalence of concordant (or discordant) conditions would be associated with better (or worse) quality of diabetes care. METHODS: We conducted a cross-sectional study using practice-level data (7,884 practices). We estimated the practice-level prevalence of diabetes and 15 other chronic conditions, which were classified as diabetes concordant (ie, with the same pathophysiologic risk profile and therefore more likely to be part of the same management plan) or diabetes discordant (ie, not directly related in either their pathogenesis or management). We measured quality of diabetes care with diabetes-specific indicators (8 processes and 3 intermediate outcomes of care). We used linear regression models to quantify the effect of the prevalence of the conditions on aggregate achievement rate for quality of diabetes care. RESULTS: Consistent with the proposed model, the prevalence rates of 4 of 7 concordant conditions (obesity, chronic kidney disease, atrial fibrillation, heart failure) were positively associated with quality of diabetes care. Similarly, negative associations were observed as predicted for 2 of the 8 discordant conditions (epilepsy, mental health). Observations for other concordant and discordant conditions did not match predictions in the hypothesized model. CONCLUSIONS: The quality of diabetes care provided in English family practices is associated with the prevalence of other major chronic conditions at the practice level. The nature and direction of the observed associations cannot be fully explained by the concordant-discordant model.
Authors: Eindra Aung; Maria Donald; Joseph Coll; Jo Dower; Gail M Williams; Suhail A R Doi Journal: Health Expect Date: 2013-10-24 Impact factor: 3.377
Authors: Carel F Schaars; Petra Denig; Willeke N Kasje; Roy E Stewart; Bruce H R Wolffenbuttel; Flora M Haaijer-Ruskamp Journal: Diabetes Care Date: 2004-01 Impact factor: 19.112
Authors: Simone R de Bruin; Sandra H van Oostrom; Hanneke W Drewes; Janneke T de Jong-van Til; Caroline A Baan; Jeroen N Struijs Journal: Int J Integr Care Date: 2013-12-23 Impact factor: 5.120
Authors: Gillian Hawthorne; Susan Hrisos; Elaine Stamp; Marko Elovainio; Jill J Francis; Jeremy M Grimshaw; Margaret Hunter; Marie Johnston; Justin Presseau; Nick Steen; Martin P Eccles Journal: PLoS One Date: 2012-07-30 Impact factor: 3.240
Authors: Robert I Griffiths; José M Valderas; Emily C McFadden; Clare R Bankhead; Bernadette A Lavery; Nada F Khan; Richard J Stevens; Nancy L Keating Journal: J Cancer Surviv Date: 2017-07-22 Impact factor: 4.442
Authors: Julia M Langton; Sabrina T Wong; Sharon Johnston; Julia Abelson; Mehdi Ammi; Fred Burge; John Campbell; Jeannie Haggerty; William Hogg; Walter P Wodchis; Kimberlyn McGrail Journal: Healthc Policy Date: 2016-11
Authors: Magdalena Nowakowska; Salwa S Zghebi; Darren M Ashcroft; Iain Buchan; Carolyn Chew-Graham; Tim Holt; Christian Mallen; Harm Van Marwijk; Niels Peek; Rafael Perera-Salazar; David Reeves; Martin K Rutter; Stephen F Weng; Nadeem Qureshi; Mamas A Mamas; Evangelos Kontopantelis Journal: BMC Med Date: 2019-07-25 Impact factor: 8.775
Authors: Subhashisa Swain; Anne Kamps; Jos Runhaar; Andrea Dell'Isola; Aleksandra Turkiewicz; Danielle Robinson; V Strauss; Christian Mallen; Chang-Fu Kuo; Carol Coupland; Michael Doherty; Aliya Sarmanova; Daniel Prieto-Alhambra; Martin Englund; Sita M A Bierma-Zeinstra; Weiya Zhang Journal: BMJ Open Date: 2022-04-06 Impact factor: 2.692
Authors: Grace Sum; Gerald Choon-Huat Koh; Stewart W Mercer; Lim Yee Wei; Azeem Majeed; Brian Oldenburg; John Tayu Lee Journal: BMC Public Health Date: 2020-01-06 Impact factor: 3.295