scholarly journals PDB62 IMPACT OF INSURANCE PAYMENT SYSTEMS ON QUALITY OF CARE AND HEALTH CARE SERVICE UTILIZATION IN TYPE 2 DIABETES MEDICAID ENROLLEES

2008 ◽  
Vol 11 (6) ◽  
pp. A516
Author(s):  
MD Pawaskar ◽  
SP Burch ◽  
MC Nahata ◽  
E Seiber ◽  
R Balkrishnan
Author(s):  
Tania Steyl ◽  
Julie Phillips

Background: Although the use of surveys has been supported for assessing understanding of health care service quality, it could also be argued that their main function is to quantify perceptions. The importance of assessing patient satisfaction in individuals’ own language has been highlighted in research. However, important culture-specific differences can be revealed during the adaptation process of a scale, and if not attended to can influence the validity ofthe scale.Objectives: The aim of this study was to assess the validity and reliability of the isiXhosa version of the Patient Survey for Quality of Care (PSQC) in primary health care (PHC) facilities in a selected district in the Western Cape, South Africa.Method: The PSQC was translated into isiXhosa by two independant translators and the translated back into English by a third translator. All three translators reviewed the back translation. Face and content validity of the scale were assessed. Fifteen isiXhosa-speaking clients with type 2 diabetes mellitus who had a mean age of 62.27 years (SD 10.33) and came from a randomly selected community health centre participated in the test-retest reliability.Results: Internal consistency of the scale was good (Cronbach alpha 0.70). Alpha values of individual items relating to quality of care as well as items flagged for inferior service quality were between 0.772 and 1.000, indicating good to high internal consistency.Conclusion: Results of this study indicated that the isiXhosa version of the PSQC was as reliable as the English version. It can be implemented at PHC level to assess isiXhosa-speaking patients’ satisfaction with health care services.


2014 ◽  
Vol 65 (11) ◽  
pp. 1392-1395 ◽  
Author(s):  
Dana Rose Garfin ◽  
Vanessa Juth ◽  
Roxane Cohen Silver ◽  
Francisco Javier Ugalde ◽  
Heiko Linn ◽  
...  

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Basilio Pintaudi ◽  
Alessia Scatena ◽  
Gabriella Piscitelli ◽  
Vera Frison ◽  
Salvatore Corrao ◽  
...  

Abstract Background The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 2 diabetes (T2D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. Methods The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD Annals initiative. Patients with T2D were stratified by cardiovascular risk. General descriptive indicators, measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. Results Overall, 473,740 subjects with type 2 diabetes (78.5% at very high cardiovascular risk, 20.9% at high risk and 0.6% at moderate risk) were evaluated. Among people with T2D at very high risk: 26.4% had retinopathy, 39.5% had albuminuria, 18.7% had a previous major cardiovascular event, 39.0% had organ damage, 89.1% had three or more risk factors. The use of DPP4-i markedly increased as cardiovascular risk increased. The prescription of secretagogues also increased and that of GLP1-RAs tended to increase. The use of SGLT2-i was still limited, and only slightly higher in subjects with very high cardiovascular risk. The overall quality of care, as summarized by the Q score, tended to be lower as the level of cardiovascular risk increased. Conclusions A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction. Several actions are necessary to improve the quality of care.


2015 ◽  
Vol 23 (2) ◽  
pp. 242-247 ◽  
Author(s):  
Wencui Han ◽  
Raj Sharman ◽  
Arvela Heider ◽  
Nancy Maloney ◽  
Min Yang ◽  
...  

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.


2015 ◽  
Vol 8 (6) ◽  
pp. 75 ◽  
Author(s):  
Mu'taman Jarrar ◽  
Hamzah Abdul Rahman ◽  
Mohammad Sobri Don

<p><strong>BACKGROUND &amp; OBJECTIVE:</strong> Demand for health care service has significantly increased, while the quality of healthcare has become both a national and an international priority. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia.</p><p><strong>DESIGN:</strong> A narrative review of the literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) and the MOH Annual Reports in Malaysia were reviewed.</p><p><strong>RESULTS: </strong>The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10<sup>th</sup> Malaysia Health Plan promotes the theme “1 Care for 1 Malaysia” in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors.</p><p><strong>CONCLUSION: </strong>There is no single intervention of optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia.</p>


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