scholarly journals Is the Safety Net Leaking?: Measuring Changes in Quality of Care and Healthcare Utilization for Patients with Diabetes Mellitus before and after Implementation of Cost-Sharing at a Public Hospital

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Deanna Willis ◽  
Yilun Wang ◽  
Jingwei Wu ◽  
Stephen Walston ◽  
Roberta Ambuehl ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Quality Of Care ◽  
Healthcare Utilization ◽  
Cost Sharing ◽  
Public Hospital ◽  
Safety Net ◽  
Before And After ◽  
Patients With Diabetes

scholarly journals Quality of care for patients with diabetes mellitus type 2 in ‘model practices’ in Slovenia – first results

2016 ◽  
Vol 55 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Davorina Petek ◽  
Mitja Mlakar
Keyword(s):  
Diabetes Mellitus ◽  
Quality Of Care ◽  
Quality Indicators ◽  
Diabetes Mellitus Type 2 ◽  
Process Quality ◽  
Diabetes Mellitus Type ◽  
Before And After ◽  
Patients With Diabetes

Abstract Background A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices. Methods A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared. Results The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort. Conclusion The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation.

scholarly journals Quality of care for patients with Diabetes Mellitus in the More Doctors Program, in a municipality in the metropolitan region of Recife (PE), Brazil

2020 ◽  
Vol 44 (125) ◽  
pp. 384-399
Author(s):  
Maria da Penha Rodrigues dos Santos ◽  
Maria do Socorro Veloso de Albuquerque ◽  
Tereza Maciel Lyra ◽  
Antonio da Cruz Gouveia Mendes ◽  
Fabiana Letícia da Silva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Quality Of Care ◽  
Assessment Tool ◽  
Metropolitan Region ◽  
Care Assessment ◽  
Patients With Diabetes ◽  
Primary Care Assessment Tool

RESUMO Avaliou-se a qualidade da atenção aos pacientes com diabetes nas equipes do Programa Mais Médicos. Tratou-se de um estudo quantitativo, transversal, realizado em Goiana, Pernambuco, entre novembro de 2016 e agosto de 2017. Utilizaram-se entrevistas estruturadas a partir do Primary Care Assessment Tool. Foram entrevistados 41 profissionais de Equipes de Saúde da Família ligadas ao Programa Mais Médicos e 437 usuários com Diabetes Mellitus acompanhados por essas equipes. Os achados demonstram que a presença regular dos médicos pode ter ocasionado bons resultados quanto à longitudinalidade (usuários: 7,1; profissionais: 8,2) e à utilização dos serviços (usuários: 8,5). A qualidade do componente sistema de informações (usuários: 7,6; profissionais: 9,2) indica preenchimento e disponibilidade de informações sobre pacientes. Deficiência estrutural do município pode ter contribuído para o baixo desempenho da acessibilidade (usuários: 3,6; profissionais: 3,9). Resultados insatisfatórios para orientação familiar (4,6) e comunitária (2,88), segundo usuários, reforçam a necessidade de fortalecimento desses atributos, peculiares à Estratégia Saúde da Família. Ademais, por tratar-se de um programa, existe a possibilidade de sua descontinuidade, sobretudo no cenário da Emenda Constitucional nº 95, de 2016, podendo comprometer o acesso e a continuidade dos cuidados, especialmente aos usuários com doenças crônicas que utilizam frequentemente o sistema de saúde.

scholarly journals The Insulin Treatment Satisfaction Questionnaire and Assessment of Satisfaction with a Latest-generation Insulin Pump

2015 ◽  
Vol 11 (2) ◽  
pp. 67
Author(s):  
Michael Bromba ◽  
Fiona Campbell ◽  
Brian L Levy ◽  
◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Quality Of Care ◽  
Treatment Satisfaction ◽  
Insulin Treatment ◽  
Insulin Pump ◽  
Previous Treatment ◽  
Improve Quality ◽  
Satisfaction Questionnaire ◽  
Patients With Diabetes

Satisfaction with the latest-generation insulin pump (LGIP) was assessed in patients with diabetes mellitus enrolled in the Comparing Perception of Insulin Therapies for T1D Patients with the Aim to Improve Quality of Care (CHOICE) study. The Insulin Treatment Satisfaction Questionnaire (ITSQ), a measure of insulin treatment satisfaction, together with additional questions assessed respondents’ perceptions of glucose control, their satisfaction with major LGIP features and preference for the LGIP versus their previous treatment, was used. The LGIP (Animas® Vibe™) was considered to be a better method for delivering insulin compared with their therapy before switching and was rated high for treatment satisfaction. These findings should be useful to clinicians when considering the possibility of transferring a patient from their existing treatment regimen to a LGIP.

scholarly journals DINÂMICA DAS ALTERAÇÕES NA FUNCIONALIDADE PSIQUÍCA E ACTIVIDADE PSICOSSOCIAL ANTES E DEPOIS DO DIAGNÓSTICO DE DIABETES MELLITUS

2020 ◽  
Vol 6 (2) ◽  
pp. 388-414
Author(s):  
Fernando Oliveira Pereira
Keyword(s):  
Diabetes Mellitus ◽  
Negative Impact ◽  
Well Being ◽  
Work Capacity ◽  
Self Assessment ◽  
Demographic Questionnaire ◽  
Before And After ◽  
Patients With Diabetes ◽  
The Impact

Conciousness is decisive in attributing meanings to the manifestations of life. The impact of diabetes mellitus on patients` psychic and psychosocial functionality depends on the understanding of the disease. Objective: to study the dynamics of changes in psychic and psychosocial functionality in patients with diabetes mellitus, before and after diagnosis. Participants: 50 subjects of both sexes, with diabetes mellitus (30 - 88 years) and 50 subjects with the same socio-demographic characteristics, who do not suffer from the disease. Methodology: Clinical-psychological interview; Socio-demographic questionnaire; Clinical-dynamic disease questionnaire; Self-assessment questionnaire on psychic, family, social and work functionality. Results: Diabetes mellitus patients in the period of life “after diagnosis”, compared to the period “before diagnosis”, show statistically significant differences of greater expressiveness psychic functionality (nervousness, anxiety, irritability, depression, pessimism and fatigue) and lower in psychosocial and work activities (work capacity, availability to socialize with friends and family). In the comparison “before diagnosis” and “current moment” there are significant differences in all categories, but if comparing “after diagnosis” and “current moment”, significant differences only exist in work capacity, fatigue, availability to live together with friends; lower values at the present time. Conclusion: The intrusion of diabetes mellitus and the patient's knowledge of the diagnosis cause changes in the dynamics of psychic functionality and psychosocial activity, aggravating the levels of nervousness, anxiety, irritability, depression, pessimism, feeling of fatigue, less work capacity, availability to socialize with friends and family. Diabetes has a negative impact on the functionality of patients, affecting well-being and quality of life.

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