Team-based care improves quality of diabetes care -Family Practice Integrated Care Project in Taiwan

Abstract Background The Family Practice Integrated Care Project (FPICP) is a team-based program in Taiwan initiated in 2003. This study investigates the influence of FPICP on the quality of diabetes care. Methods This population-based cohort study used Taiwan’s National Health Insurance Administration data on FPICP (fiscal year 2015–2016, with follow-up duration of one year). Participants included diabetic patients aged ≥30 in primary care clinics. We used conditional logistic regression modeling of patient characteristics and annual diabetes examinations and compared FPICP participants with non-participating candidates. Main outcome measures included completion of annual diabetes examinations, including glycated hemoglobin (A1c), low-density lipoprotein (LDL), urine microalbumin (MAU), routine urinalysis (UR), and fundus examination (FE). Results The sample included 298,208 FPICP participants and 478,778 non-participating candidates. After 1:1 propensity score matching, the examination completion rates for FPICP participants and non-participants, respectively, were 94.4% versus 93.6% in A1c, 84.2% versus 83.8% in LDL, 61.9% versus 60.1% in MAU, 59.2% versus 58.0% in UR, and 30.1% versus 32.4% in FE. Conclusion Our findings indicate that a program like FPICP helps improve the quality of diabetes care through regular examinations of Alc, LDL, MAU, and UR.

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Trends and Disparities in Quality of Diabetes Care in the US: The National Health and Nutrition Examination Survey, 1999-2016

INNOVATIONS in pharmacy ◽

10.24926/iip.v10i4.2064 ◽

2019 ◽

Vol 10 (4) ◽

pp. 17

Author(s):

Shweta Kamat ◽

Yolene Gousse ◽

Jagannath Muzumdar ◽

Anna Gu

Keyword(s):

Health Insurance ◽

Diabetes Care ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

The United States ◽

Original Research ◽

The Past ◽

Diabetes Educator ◽

Quality Of Diabetes Care

Objectives: To examine trends and disparities in the quality of diabetes care among US adults with diabetes. Methods: Individuals aged 20 years or older with diabetes from NHANES (1999-2016) were included in the study. Quality indicators for diabetes care included Hemoglobin A1c (HbA1c) < 8%, Blood Pressure (BP) < 130/80 mm Hg, Low-Density Lipoprotein (LDL-C) < 100 mg/dL, triglycerides < 150 mg/dL, receiving eye and foot examinations in the past year, and meeting with a diabetes educator in the past year. Results: A total of 7,521 adults with diabetes were identified. During the 18-year study period, significant improvements in diabetes care were observed in the overall study sample. Adjusted regression analyses showed that compared with their White counterparts, Blacks were more likely to have received eye (OR=1.37; P=0.01) and foot (OR=1.42;P=0.01) examinations and met a diabetes educator (OR=1.40;P<0.01) over the past year. However, Blacks were significantly less likely to achieve treatment goals for HbA1c (OR=0.77, P=0.02), BP (OR=0.75, P<0.01), LDL-C (OR=0.68, P<0.01). Hispanics in general had suboptimal healthcare utilization for diabetes but the Hispanic-white disparities in diabetes care outcomes were attenuated after controlling for patient sociodemographic, clinical and utilization characteristics. Overall, suboptimal quality of diabetes care were particularly prominent among adults without health insurance and those with lower educational attainment. Conclusions: In the United States, despite persistent efforts, racial disparities in quality of diabetes care still persist. Lack of health insurance and lower socioeconomic status are among the strongest predictors of poor quality of diabetes care. These findings provide valuable information in developing policies and practices to promote racial equity in diabetes care. Article Type: Original Research

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Quality of Diabetes Care in Primary Health Centres in North Al-Batinah of Oman

The Open Cardiovascular Medicine Journal ◽

10.2174/1874192401408010048 ◽

2014 ◽

Vol 8 (1) ◽

pp. 48-54 ◽

Cited By ~ 2

Author(s):

Mohammed Al-Shafaee ◽

Yousuf Al-Farsi ◽

Yousuf Al-Kaabi ◽

Yajnavalka Banerjee ◽

Najat Al-Zadjali ◽

...

Keyword(s):

Diabetes Care ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Poor Quality ◽

Cross Sectional ◽

Primary Health ◽

Quality Of Diabetes Care ◽

The Mean

Objective: To assess the quality of diabetic care provided in primary health care settings in Oman. Methods: This was a cross-sectional study of randomly selected 500 patients with diabetes mellitus (DM) attending 6 primary care diabetic clinics in the north Al-Batinah region of Oman from January to December 2010. Nine standards on the quality of diabetes care were audited. Results: The mean age of the sample was 51±13 years, ranging from 15 to 87 years; the majority (61%) were females. The mean duration of DM was 4±3 years, ranging from 1 to 18 years. Seventy-seven percent of the patients attended diabetic clinics at least 4 times per year. Of the 9 assessed diabetic standards, HbA1c was documented in 33% of the patients, body mass index in 12%, low-density lipoprotein cholesterol (LDL-C) in 40%, urinary albumin:creatinine ratio in 28%, creatinine in 63% and blood pressure (BP) in 96%. Optimal control among the documented indicators was noted in 32, 21, 25, 85, 95 and 19%, respectively. Twenty percent of the patients had their ECGs done while only 39% of the patients had foot examination. No patient had attained control in all of HbA1c., BP and LDL-C. Conclusion: There is a gap between the recommended DM care guidelines and current practice with consequent poor quality of care in these patients.

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Quality of diabetes care in Austrian diabetic patients willing to participate in a DMP – at baseline

Wiener klinische Wochenschrift ◽

10.1007/s00508-011-1600-9 ◽

2011 ◽

Vol 123 (13-14) ◽

pp. 436-443 ◽

Cited By ~ 7

Author(s):

Maria Flamm ◽

Henrike Winkler ◽

Sigrid Panisch ◽

Peter Kowatsch ◽

Gert Klima ◽

...

Keyword(s):

Diabetes Care ◽

Diabetic Patients ◽

Quality Of Diabetes Care

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Building the evidence for integrated care for type 2 diabetes: a pilot study

Australian Journal of Primary Health ◽

10.1071/py15020 ◽

2016 ◽

Vol 22 (5) ◽

pp. 409 ◽

Cited By ~ 2

Author(s):

Jessica L. Browne ◽

Jane Speight ◽

Carina Martin ◽

Christopher Gilfillan

Keyword(s):

Type 2 Diabetes ◽

Integrated Care ◽

Diabetes Care ◽

Controlled Trial ◽

Care Model ◽

Service Setting ◽

Quality Of Diabetes Care ◽

The Impact

Integrated care models have the potential to reduce fragmentation in the health system and improve outcomes for people with type 2 diabetes. A pilot evaluation of an integrated care model for people with type 2 diabetes in Melbourne, Australia, is reported on. Two studies were conducted: (1) a 6-month pilot randomised controlled trial (n=56) evaluating the impact of the integrated care model relative to hospital outpatient clinics; and (2) a cross-sectional study (n=92) of patients attending the two services. The primary outcome was diabetes-specific distress; secondary outcomes were perceived quality of diabetes care, diabetes-specific self-efficacy and glycated haemoglobin (HbA1c). There was no effect of service setting on diabetes-specific distress. Participants from the integrated care setting perceived the quality of diabetes care to be higher than did participants from the hospital clinics. Significant HbA1c improvements were observed over time, but with no effect of service setting. The model holds promise for people with type 2 diabetes who need more specialist/multidisciplinary care than can be provided in primary care. Patients’ evaluations of the quality of diabetes care received at the integrated care service are very positive, which is likely to be one of the key strengths of the integrated model.

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Quality of diabetes care and needs for education in non-insulin-dependent diabetic patients from the Moscow region

Patient Education and Counseling ◽

10.1016/0738-3991(94)90260-7 ◽

1994 ◽

Vol 23 ◽

pp. S68 ◽

Cited By ~ 1

Author(s):

M. Antsiferov ◽

E. Surkova ◽

A. Maiorov ◽

I. Dedov

Keyword(s):

Diabetes Care ◽

Moscow Region ◽

Diabetic Patients ◽

Quality Of Diabetes Care ◽

Insulin Dependent ◽

Insulin Dependent Diabetic

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The health care for diabetic persons in Italy: the QUADRI survey

Clinical Management Issues ◽

10.7175/cmi.v2i3.572 ◽

2008 ◽

Vol 2 (3) ◽

pp. 143-149

Author(s):

Marina Maggini ◽

Valerio Aprile ◽

Sandro Baldissera ◽

Angelo D’Argenzio ◽

Salvatore Lopresti ◽

...

Keyword(s):

Diabetes Care ◽

Diabetic Patients ◽

Haemoglobin A1c ◽

Optimal Care ◽

The Past ◽

Italian National Health Service ◽

Quality Of Diabetes Care ◽

Italian National Health ◽

Integrated Case Management

To obtain regional and national data on the quality of diabetes care within the Italian National Health Service, a national survey among persons with diabetes was conducted in 2004. A sample of 3,426 diabetic patients (age 18-64 years) were interviewed using a standardized questionnaire. The population was middle-aged (median age 57 years), had a low educational level, and was followed primarily in public diabetes centres. A total of 54% reported having hypertension but 14% were not on treatment; for hypercholesterolemia, the corresponding figures were 44% and 26%. Of the 72% who were overweight or obese, 51% were trying to lose weight; 26% currently smoked. Only 66% of patients had undergone haemoglobin A1c testing in the past four months (among the 67% who had ever heard of test); 30% suffered from microvascular or macrovascular complications. Only 5% received all eight main tests recommended by the guidelines within the specified intervals. Our study demonstrates that diabetic patients receive less than optimal care, they are engaged in unhealthy behaviours and received inadequate treatment for comorbidities, and that the translation of guidelines into clinical practice was unsatisfactory. These data have been used to formulate national and regional policy regarding integrated case management to improve the quality of diabetes care.

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Program Lifts The Quality of Diabetes Care

Family Practice News ◽

10.1016/s0300-7073(10)70920-8 ◽

2010 ◽

Vol 40 (14) ◽

pp. 58-59

Author(s):

MICHELE G. SULLIVAN

Keyword(s):

Diabetes Care ◽

Quality Of Diabetes Care

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Understanding the quality of diabetes care in Japan: a systematic review of the literature

Diabetology International ◽

10.1007/s13340-021-00497-3 ◽

2021 ◽

Author(s):

Joanna Mitri ◽

Takehiro Sugiyama ◽

Hirokazu Tanaka ◽

Mitsuru Ohsugi ◽

Robert A. Gabbay

Keyword(s):

Systematic Review ◽

Diabetes Care ◽

Review Of The Literature ◽

Quality Of Diabetes Care

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Application of the Ottawa Charter Five Priority Areas of Action for Public Health to an Institution-Wide Diabetes Care Promotion

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041543 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1543

Author(s):

Min-Hua Lin ◽

She-Yu Chiu ◽

Wen-Chao Ho ◽

Hui-Ying Huang

Keyword(s):

Public Health ◽

Quality Of Life ◽

Health Promotion ◽

Diabetes Care ◽

Hospital Staff ◽

Health Promotion Program ◽

Diabetic Patients ◽

Health Promoting ◽

Diabetes Patients

This study was the first institution-wide health promotion program in Taiwan to apply the five priority areas for taking action in public health highlighted in the Ottawa Charter for diabetes patients. We aimed to improve the quality of home care received by diabetic patients by training health care professionals in health promotion. This program consisted of developing personal skills, reorienting health services, strengthening community actions, creating supportive environments, and building healthy public policy. It was applied in the Yunlin Christian Hospital located in central Taiwan from August 2011 to November 2011. A health-promoting education course consisting of weight control, diabetes care, and quality management for diabetes was developed and applied to all 323 hospital staff. Then, hospital staff volunteers and diabetes patients were recruited to participate in the program. A total of 61 staff volunteers and 90 diabetes patients were involved in this study. Staff volunteers were trained to participate in communities to provide care and guidance to patients with diabetes. The World Health Organization Quality of Life(WHOQOL)-BREF-Taiwan Version questionnaires were investigated before and after implementation of this program for the patients. A health-promoting lifestyle profile questionnaire was filled by the staff. The investigation data were then analyzed by statistical methods. The diabetes patients experienced a significant increase in their satisfaction with health and health-related quality of life as well as significant improvements in health-promotion and self-management behaviors (p < 0.05). In addition, staff volunteers significantly consumes food from the five major groups than the other staff (p < 0.05). Various improvements in health-promoting behaviors were observed amongst the hospital staff and the diabetic patients. Our project could be a reference for other medical organizations to implement an institution-wide health-promotion program for diabetic patients.

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