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Article: Quality of care and volume for patients with diabetes mellitus in the primary care setting: a population based retrospective cohort study

TitleQuality of care and volume for patients with diabetes mellitus in the primary care setting: a population based retrospective cohort study
Authors
Issue Date2016
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/diabres
Citation
Diabetes Research and Clinical Practice, 2016, v. 120, p. 171-181 How to Cite?
AbstractAims: To examine the association of patient volume with quality of diabetes care in the primary care setting. Methods: We analyzed population-based data from Hospital Authority administrative database using a Hong Kong representative sample of 187,031 diabetic patients managed in 74 primary care general outpatient clinics between 04/2011-03/2012. We assessed the associations between annual clinic-based patient volume and quality of care in terms of adherence to care criteria of process (HbA1c test, renal function test, full lipid profile, urine protein analysis, diabetic retinopathy screening, and appropriate drug prescription) and clinical outcomes (HbA1c≤7%, BP≤130/80mmHg, LDL-C≤2.6mmol/L) of care criteria, with and without adjustment for patient and clinic characteristics. Results: Patient volume was associated with three of seven process of care criteria; however, when compared to clinics in higher volume quartiles, those in lowest-volume quartile had more odds of HbA1c test (odds ratios (OR): 0.781, 0.655 and 0.646 for quartile from 2 to 4, respectively), renal function test (OR: 0.357, 0.367 and 0.590 for quartile from 2 to 4, respectively), and full lipid profile test (OR: 0.508, 0.612 and 0.793 for quartile from 2 to 4, respectively). There was no significant association between patient volume and the standards of achieving of HbA1c, BP and LDL-C outcome targets. Conclusions: Disparities in volume and quality of diabetes care were observed in public primary care setting. Lower patient volumes at clinic level were associated with greater adherence to three process criteria but a volume-outcome association was not present.
Persistent Identifierhttp://hdl.handle.net/10722/229278
ISSN
2015 Impact Factor: 3.045
2015 SCImago Journal Rankings: 1.338
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, CKH-
dc.contributor.authorFung, SCC-
dc.contributor.authorKung, K-
dc.contributor.authorWan, YF-
dc.contributor.authorYu, YTE-
dc.contributor.authorChan, KC-
dc.contributor.authorLam, CLK-
dc.date.accessioned2016-08-23T14:10:04Z-
dc.date.available2016-08-23T14:10:04Z-
dc.date.issued2016-
dc.identifier.citationDiabetes Research and Clinical Practice, 2016, v. 120, p. 171-181-
dc.identifier.issn0168-8227-
dc.identifier.urihttp://hdl.handle.net/10722/229278-
dc.description.abstractAims: To examine the association of patient volume with quality of diabetes care in the primary care setting. Methods: We analyzed population-based data from Hospital Authority administrative database using a Hong Kong representative sample of 187,031 diabetic patients managed in 74 primary care general outpatient clinics between 04/2011-03/2012. We assessed the associations between annual clinic-based patient volume and quality of care in terms of adherence to care criteria of process (HbA1c test, renal function test, full lipid profile, urine protein analysis, diabetic retinopathy screening, and appropriate drug prescription) and clinical outcomes (HbA1c≤7%, BP≤130/80mmHg, LDL-C≤2.6mmol/L) of care criteria, with and without adjustment for patient and clinic characteristics. Results: Patient volume was associated with three of seven process of care criteria; however, when compared to clinics in higher volume quartiles, those in lowest-volume quartile had more odds of HbA1c test (odds ratios (OR): 0.781, 0.655 and 0.646 for quartile from 2 to 4, respectively), renal function test (OR: 0.357, 0.367 and 0.590 for quartile from 2 to 4, respectively), and full lipid profile test (OR: 0.508, 0.612 and 0.793 for quartile from 2 to 4, respectively). There was no significant association between patient volume and the standards of achieving of HbA1c, BP and LDL-C outcome targets. Conclusions: Disparities in volume and quality of diabetes care were observed in public primary care setting. Lower patient volumes at clinic level were associated with greater adherence to three process criteria but a volume-outcome association was not present.-
dc.languageeng-
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/diabres-
dc.relation.ispartofDiabetes Research and Clinical Practice-
dc.rightsPosting accepted manuscript (postprint): © <year>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/-
dc.titleQuality of care and volume for patients with diabetes mellitus in the primary care setting: a population based retrospective cohort study-
dc.typeArticle-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailFung, SCC: cfsc@hku.hk-
dc.identifier.emailKung, K: kkung@HKUCC-COM.hku.hk-
dc.identifier.emailWan, YF: yfwan@hku.hk-
dc.identifier.emailYu, YTE: ytyu@hku.hk-
dc.identifier.emailChan, KC: kcchanae@hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityFung, SCC=rp01330-
dc.identifier.authorityKung, K=rp01974-
dc.identifier.authorityYu, YTE=rp01693-
dc.identifier.authorityLam, CLK=rp00350-
dc.identifier.doi10.1016/j.diabres.2016.07.029-
dc.identifier.pmid27568647-
dc.identifier.scopuseid_2-s2.0-84983678488-
dc.identifier.hkuros261356-
dc.identifier.volume120-
dc.identifier.spage171-
dc.identifier.epage181-
dc.identifier.isiWOS:000386750900023-
dc.publisher.placeIreland-

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