Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study
Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electroni...
Ausführliche Beschreibung
Autor*in: |
Lavens, Astrid [verfasserIn] |
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E-Artikel |
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Englisch |
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2016 |
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Anmerkung: |
© Lavens et al. 2016 |
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Übergeordnetes Werk: |
Enthalten in: BMC health services research - London : BioMed Central, 2001, 16(2016), 1 vom: 23. Aug. |
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Übergeordnetes Werk: |
volume:16 ; year:2016 ; number:1 ; day:23 ; month:08 |
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DOI / URN: |
10.1186/s12913-016-1670-5 |
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Katalog-ID: |
SPR028282027 |
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520 | |a Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. | ||
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700 | 1 | |a Van Casteren, Viviane |4 aut | |
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10.1186/s12913-016-1670-5 doi (DE-627)SPR028282027 (SPR)s12913-016-1670-5-e DE-627 ger DE-627 rakwb eng Lavens, Astrid verfasserin aut Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Lavens et al. 2016 Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. Threshold measure (dpeaa)DE-He213 Clinical action measure (dpeaa)DE-He213 Quality of care (dpeaa)DE-He213 Diabetes (dpeaa)DE-He213 Benchmarking (dpeaa)DE-He213 Feedback (dpeaa)DE-He213 Doggen, Kris aut Mathieu, Chantal aut Nobels, Frank aut Vandemeulebroucke, Evy aut Vandenbroucke, Michel aut Verhaegen, Ann aut Van Casteren, Viviane aut Enthalten in BMC health services research London : BioMed Central, 2001 16(2016), 1 vom: 23. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:16 year:2016 number:1 day:23 month:08 https://dx.doi.org/10.1186/s12913-016-1670-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 23 08 |
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10.1186/s12913-016-1670-5 doi (DE-627)SPR028282027 (SPR)s12913-016-1670-5-e DE-627 ger DE-627 rakwb eng Lavens, Astrid verfasserin aut Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Lavens et al. 2016 Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. Threshold measure (dpeaa)DE-He213 Clinical action measure (dpeaa)DE-He213 Quality of care (dpeaa)DE-He213 Diabetes (dpeaa)DE-He213 Benchmarking (dpeaa)DE-He213 Feedback (dpeaa)DE-He213 Doggen, Kris aut Mathieu, Chantal aut Nobels, Frank aut Vandemeulebroucke, Evy aut Vandenbroucke, Michel aut Verhaegen, Ann aut Van Casteren, Viviane aut Enthalten in BMC health services research London : BioMed Central, 2001 16(2016), 1 vom: 23. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:16 year:2016 number:1 day:23 month:08 https://dx.doi.org/10.1186/s12913-016-1670-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 23 08 |
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10.1186/s12913-016-1670-5 doi (DE-627)SPR028282027 (SPR)s12913-016-1670-5-e DE-627 ger DE-627 rakwb eng Lavens, Astrid verfasserin aut Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Lavens et al. 2016 Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. Threshold measure (dpeaa)DE-He213 Clinical action measure (dpeaa)DE-He213 Quality of care (dpeaa)DE-He213 Diabetes (dpeaa)DE-He213 Benchmarking (dpeaa)DE-He213 Feedback (dpeaa)DE-He213 Doggen, Kris aut Mathieu, Chantal aut Nobels, Frank aut Vandemeulebroucke, Evy aut Vandenbroucke, Michel aut Verhaegen, Ann aut Van Casteren, Viviane aut Enthalten in BMC health services research London : BioMed Central, 2001 16(2016), 1 vom: 23. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:16 year:2016 number:1 day:23 month:08 https://dx.doi.org/10.1186/s12913-016-1670-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 23 08 |
allfieldsGer |
10.1186/s12913-016-1670-5 doi (DE-627)SPR028282027 (SPR)s12913-016-1670-5-e DE-627 ger DE-627 rakwb eng Lavens, Astrid verfasserin aut Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Lavens et al. 2016 Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. Threshold measure (dpeaa)DE-He213 Clinical action measure (dpeaa)DE-He213 Quality of care (dpeaa)DE-He213 Diabetes (dpeaa)DE-He213 Benchmarking (dpeaa)DE-He213 Feedback (dpeaa)DE-He213 Doggen, Kris aut Mathieu, Chantal aut Nobels, Frank aut Vandemeulebroucke, Evy aut Vandenbroucke, Michel aut Verhaegen, Ann aut Van Casteren, Viviane aut Enthalten in BMC health services research London : BioMed Central, 2001 16(2016), 1 vom: 23. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:16 year:2016 number:1 day:23 month:08 https://dx.doi.org/10.1186/s12913-016-1670-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 23 08 |
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10.1186/s12913-016-1670-5 doi (DE-627)SPR028282027 (SPR)s12913-016-1670-5-e DE-627 ger DE-627 rakwb eng Lavens, Astrid verfasserin aut Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Lavens et al. 2016 Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. Threshold measure (dpeaa)DE-He213 Clinical action measure (dpeaa)DE-He213 Quality of care (dpeaa)DE-He213 Diabetes (dpeaa)DE-He213 Benchmarking (dpeaa)DE-He213 Feedback (dpeaa)DE-He213 Doggen, Kris aut Mathieu, Chantal aut Nobels, Frank aut Vandemeulebroucke, Evy aut Vandenbroucke, Michel aut Verhaegen, Ann aut Van Casteren, Viviane aut Enthalten in BMC health services research London : BioMed Central, 2001 16(2016), 1 vom: 23. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:16 year:2016 number:1 day:23 month:08 https://dx.doi.org/10.1186/s12913-016-1670-5 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 23 08 |
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clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study |
title_auth |
Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study |
abstract |
Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. © Lavens et al. 2016 |
abstractGer |
Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. © Lavens et al. 2016 |
abstract_unstemmed |
Background Assessment of quality of care using classical threshold measures (TM) is open to debate. Measures that take into account the clinician’s actions and the longitudinal nature of chronic care are more reliable, although their major limitation is that they require more sophisticated electronic health records. We created a clinical action measure (CAM) for the control of LDL and non-HDL cholesterol from low-complexity data, and investigated how quality of care in individual diabetes centres based on the CAM is related to that based on the classical TM. Methods Data was used from 3421 diabetes patients treated in 95 centres, collected in two consecutive retrospective data collections. Patients met the TM when their index value was below target. Patients met the CAM when their index value was below target or above target but for whom treatment initiation or intensification, or possible contraindication, was indicated. Results Based on the TM, 60–70 % of the patients received good care. This percentage increased significantly using the CAM (+5 %, p < 0.001). At the centre level, the CAM was associated with a higher median score, and a change in position among centres (‘poor’, ‘good’ or ‘excellent’ performer) for 5–10 % of the centres. Conclusions Judging quality of diabetes care of a centre based on a TM may be misleading. Low-complexity data available from a quality improvement initiative can be used to construct a more fair and feasible measure of quality of care. © Lavens et al. 2016 |
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title_short |
Clinical action measures improve the reliability of feedback on quality of care in diabetes centres: a retrospective cohort study |
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Doggen, Kris Mathieu, Chantal Nobels, Frank Vandemeulebroucke, Evy Vandenbroucke, Michel Verhaegen, Ann Van Casteren, Viviane |
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