P-138: Factors affecting the quality of care among high blood pressure diabetic patients in Tunisia

2015 ◽  
Vol 64 ◽  
pp. S70
Author(s):  
M. Ben Cheikh ◽  
M. Omri ◽  
S. Mhidhli ◽  
T. Harrabi ◽  
H. Mhalla ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Quality Of Care ◽  
High Blood Pressure ◽  
Diabetic Patients ◽  
Factors Affecting

Abstract 306: Guideline-based Strategies for Improving Control of High Blood Pressure: The 2019 Acc/Aha Performance and Quality Measures for Adults With High Blood Pressure

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Donald E Casey
Keyword(s):  
Blood Pressure ◽  
Quality Of Care ◽  
High Blood Pressure ◽  
Clinical Performance ◽  
Quality Measures ◽  
Structural Quality ◽  
Fee For Service ◽  
And Control ◽  
Detection Evaluation

Despite a 27% reduction in all-cause mortality from targeting a systolic blood pressure of &lt 120 mm Hg, as compared with &lt 140 mm Hg, existing quality measures from the NCQA for controlling HBP (for hypertensive adults 18-59 years of age whose blood pressure was &lt 140/90 mm Hg) have not changed substantially over the past several years for a variety of insured populations, including commercial, Medicaid, Medicare Fee for Service and Medicare Advantage. Re-examining both the targets and processes of managing HBP are thus warranted to help support the use of the latest evidence in optimizing the quality of care and outcomes for patients with HBP. The recently published 2019 ACC/AHA Clinical Performance and Quality Measures for Adults with High Blood Pressure are designed to promote improvements in diagnosis and control of high blood pressure, including a new emphasis on “structural” quality measures that focus on a comprehensive system of care as outlined in the 2017 2017 ACC/AHA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. The purpose of this presentation will be to provide a detailed overview of this new measure set as a “Blueprint for Change” necessary to overcome current health system inertia and ensure the achievement of better quality of care for people with High Blood Pressure.

scholarly journals Impact of electronic diabetes registry ‘Meaningful Use’ on quality of care and hospital utilization

2015 ◽  
Vol 23 (2) ◽  
pp. 242-247 ◽  
Author(s):  
Wencui Han ◽  
Raj Sharman ◽  
Arvela Heider ◽  
Nancy Maloney ◽  
Min Yang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Hierarchical Linear Modeling ◽  
Meaningful Use ◽  
Hospital Utilization ◽  
Utilization Rate ◽  
Diabetic Patients ◽  
Diabetes Registry

Abstract Objective To investigate whether the use of diabetes registries meeting Meaningful Use core objectives in primary care practices is associated with differences in quality of care and hospital utilization rates. Materials and methods A practice assessment survey was conducted to identify whether and how practices were using diabetes registries. Insurance claims data from 2010 were used to compare the health outcomes of patients from practices that used diabetes registries meeting Meaningful Use–related objectives to the outcomes of patients from other practices. Logistic hierarchical linear modeling was used to analyze the data. Results Records from 12,514 diabetic patients (including 10 809 with type 2 diabetes) from 50 urban practices were included in the analysis. The results suggest that patients with type 2 diabetes who were treated in practices using registries for patient reminders were more likely to have completed the recommended laboratory testing (odds ratio [OR] 1.26, p < 0.01) and dilated retinal examinations (OR 1.14, p < 0.01). Patients in practices using registries for quality improvement were less likely to have ‘avoidable hospitalization’ (OR 0.83, p < 0.01) and emergency room visits (OR 0.76, p < 0.01). The use of a diabetes registry did not have a significant impact on the quality of care or hospital utilization for patients with type 1 diabetes. Conclusion Use of diabetes registries meeting Meaningful Use core objectives is associated with higher completion or recommended lab tests and a lower hospital utilization rate for patients with type 2 diabetes.

Abstract 121: Testing Frequency Of Guideline-recommended Diabetes Performance Measures In A Cohort Of Post-acute Myocardial Infarction (AMI) Diabetics.

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Sood Kisra ◽  
John Spertus ◽  
Faraz Kureshi ◽  
Philip G Jones ◽  
Mikhail Kosiborod ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Quality Of Care ◽  
Performance Measures ◽  
High Risk Group ◽  
Diabetic Patients ◽  
Testing Frequency ◽  
Patient Reported ◽  
Using Data

Background: Diabetes mellitus (DM) is common among patients hospitalized with acute myocardial infarction (AMI). Although guideline-supported performance measures exist to improve care for each condition, prior work assessing the quality of care for diabetic patients after AMI has focused only on adherence to CAD performance measures. The quality of diabetic care these patients’ receive is unknown. Methods: Using data from a prospective AMI registry (TRIUMPH), we identified patients with known DM and examined whether DM-focused performance measures had been applied over the 12 months after discharge. We focused upon 3 DM guideline-supported performance measures: a dilated eye exam, detailed foot exam, and HgbA1C testing. For this analysis, we conducted univariate statistics to describe the frequencies with which diabetics reported receiving these DM performance measures and 4 CAD performance measures at their 12-month interview. Results: Among 1,343 patients with a known diagnosis of diabetes presenting with an AMI, a total of 791 (58.9%) completed the 12-month follow up interview. The mean age (SD) of the analytic cohort was 6111 years, with 60% being males and 63% Caucasian. The frequencies of reported receipt among the examined DM and CAD performance measures ranged from 57.3%- 82.2%, with ASA being the most common and a dilated eye exam being the least (Figure). Only 47% of patients reported receiving all three DM performance measures over the past 12 months, while 41.1% reported receiving either one or two, and 12% reported receiving none. Conclusion: In a large, multi-center cohort of diabetic AMI survivors we found that patient-reported receipt of 3 DM and 4 CAD performance measures is sub-optimal and there is significant room for improvement. Novel strategies and approaches for assessing the quality of care delivered to post-AMI diabetics in a multidimensional fashion remains vital for improving care and outcomes in this high-risk group of patients. Characters: 1,683 + figure 500. Limit 2,500

P3415Will less developed countries be capable of giving high-quality universal coverage to cardiovascular disease survivors? Results from a national health survey, Chile ENS 2016–2017

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Margozzini ◽  
A Passi ◽  
M Kruk ◽  
G Danaei
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Health Care ◽  
Quality Of Care ◽  
National Health ◽  
Health Survey ◽  
Universal Coverage ◽  
National Health Survey ◽  
High Quality

Abstract Background Chilean Health System has fully implemented Universal Health Coverage (UHC) for acute cardiovascular events since 2005. Age-adjusted cardiovascular mortality has decreased, but there is limited information about coverage and quality of chronic health care given to cardiovascular disease (CVD) survivors at the national level. Purpose To assess the prevalence and quality of care in Chilean adult CVD survivors. Methods Chilean National Health Survey 2016–2017 (ENS 2016–2017) is a random stratified multistage sample of non-institutionalized population over 14 years (n=6240). Age, education, gender, rural/urban and geographical area weighted prevalence of CVD survivors (self-reported medical diagnosis of myocardial infarction or cerebrovascular attack) were calculated. High quality of care was defined as meeting six criteria simultaneously: under 70mg% LDL- C level, statin use, aspirin use, blood pressure under 130/80 mmHg, HgA1C<7 or 8 (>74-year-old) and non-smoking. Quality of care was explored using multivariate linear and logistic regression adjusting by age, gender, education and year of diagnosis (before or after UHC). Results Weighted national prevalence of CVD survivors in over 20-year-old population was 6.1%. The sample size for the CVD survivor analyses was n=455. 28.7% of CVS had their first event before the year 2005 (n=141). Overall 27.9% had LDL-C under 70mg%, 37.8% used statins, 41.4% used aspirin, 37.8% had controlled blood pressure, 78.3% were non-smokers and 84.3% had good glycemic control. National “high quality of care” prevalence in CVD survivors was 0.3%, 0.4% and 0.1% for men and women respectively. LDL and Blood pressure control prevalence (meet both criteria simultaneously) was 4,4%. In the adjusted multivariate model age was associated to a higher number of quality criteria achievement. Conclusion The number of CVD survivors in Chile is a huge challenge for the health care system. Universal coverage does not guarantee the quality of chronic life long care. Specific surveillance in high-risk population is needed to assess the system's effectiveness and accountability. Acknowledgement/Funding ENS 2016-2017 was funded by the chilean Ministry of Health (MINSAL)

scholarly journals Evaluation of Quality and Readability of Online Health Information on High Blood Pressure Using DISCERN and Flesch-Kincaid Tools

2020 ◽  
Vol 10 (9) ◽  
pp. 3214
Author(s):  
Muhammad Tahir ◽  
Muhammad Usman ◽  
Fazal Muhammad ◽  
Shams ur Rehman ◽  
Imran Khan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Information ◽  
High Blood Pressure ◽  
Statistical Significance ◽  
Treatment Options ◽  
Online Health Information ◽  
High Quality ◽  
Average Value ◽  
Pertinent Data

High Blood Pressure (BP) is a vital factor in the development of cardiovascular diseases worldwide. For more than a decade now, patients search for quality and easy-to-read Online Health Information (OHI) for symptoms, preventions, therapy and other medical conditions. In this paper, we evaluate the quality and readability of OHI about high BP. In order that the first 20 clicks of three top-rated search engines have been used to collect the pertinent data. Using the exclusion criteria, 25 unique websites are selected for evaluation. The quality of all included links is evaluated through DISCERN checklist, a questionnaire for assessing the quality of written information for a health problem. To enhance the reliability of evaluation, all links are separately assessed by two different groups—a group of Health Professional (HPs) and a group of Lay Subjects (LS). A readability test is performed using Flesch-Kincaid tool. Fleiss’ kappa has been calculated before considering average value of each group. After evaluation, the average DISCERN value of HPs is 49.43 ± 14.0 (fair quality) while for LS, it is 48.7 ± 12.2; the mean Flesch-Reading Ease Score (FRES) is 58.5 ± 11.1, which is fairly difficult to read and the Average Grade Level (AGL) is 8.8 ± 1.9. None of the websites scored more than 73 (90%). In both groups, only 4 (16%) websites achieved DISCERN score over 80%. Mann-Whitney and Cronbach’s alpha have been computed to check the statistical significance of the difference between two groups and internal consistency of DISCERN checklist, respectively. Normality and homoscedasticity tests have been performed to check the distribution of scores of both evaluating groups. In both groups, information category websites achieved high DISCERN score but their readability level is worse. Highest scoring websites have clear aim, succinct source and high quality of information on treatment options. High BP is a pervasive disease, yet most of the websites did not produce precise or high-quality information on treatment options.

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