Trends over 8 years in quality of diabetes care: results of the AMD Annals continuous quality improvement initiative View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-12-21

AUTHORS

Maria Chiara Rossi, Riccardo Candido, Antonio Ceriello, Antonino Cimino, Paolo Di Bartolo, Carlo Giorda, Katherine Esposito, Giuseppe Lucisano, Marina Maggini, Edoardo Mannucci, Illidio Meloncelli, Antonio Nicolucci, Fabio Pellegrini, Marco Scardapane, Giacomo Vespasiani

ABSTRACT

Objective Quality of care monitoring is a key strategy for health policy. In Italy, the AMD Annals continuous monitoring and quality improvement initiative has been in place since 2006. Results after 8 years are now available.Research design and methodsQuality of diabetes care indicators during the years 2004–2011 were extracted from electronic medical records of 300 diabetes clinics. From 200,000 to 500,000 patients with type 2 diabetes were analyzed per year. Six process indicators, eight intermediate outcome indicators, seven indicators of treatment intensity/appropriateness, and a quality of care summary score (Q score) were evaluated. Previous studies documented that the risk of developing a new cardiovascular event was 80 % higher in patients with a Q score <15 and 20 % higher in those with a score between 15 and 25, as compared to those with a score >25.ResultsThe proportion of patients with HbA1c ≤7 %, LDL cholesterol <100 mg/dl, and blood pressure ≥140/90 mmHg increased by 4.8, 21.9, and 10.0 %, respectively. Process and treatment intensity/appropriateness indicators consistently improved. The proportion of patients with a Q score <15 decreased from 13.5 to 6.5 %, while those with a Q score >25 increased from 22.9 to 38.5 %.ConclusionsAMD Annals document the progress in quality of diabetes care. Longitudinal improvements in Q score can translate into less cardiovascular events, with evident clinical and economic implications. AMD Annals represent a physician-led effort not requiring allocation of extra-economic resources, which is easy to implement and deeply rooted in routine clinical practice. They are a potential case model for other healthcare systems. More... »

PAGES

557-571

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00592-014-0688-6

DOI

http://dx.doi.org/10.1007/s00592-014-0688-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1027960230

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25528003


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23 schema:description Objective Quality of care monitoring is a key strategy for health policy. In Italy, the AMD Annals continuous monitoring and quality improvement initiative has been in place since 2006. Results after 8 years are now available.Research design and methodsQuality of diabetes care indicators during the years 2004–2011 were extracted from electronic medical records of 300 diabetes clinics. From 200,000 to 500,000 patients with type 2 diabetes were analyzed per year. Six process indicators, eight intermediate outcome indicators, seven indicators of treatment intensity/appropriateness, and a quality of care summary score (Q score) were evaluated. Previous studies documented that the risk of developing a new cardiovascular event was 80 % higher in patients with a Q score <15 and 20 % higher in those with a score between 15 and 25, as compared to those with a score >25.ResultsThe proportion of patients with HbA1c ≤7 %, LDL cholesterol <100 mg/dl, and blood pressure ≥140/90 mmHg increased by 4.8, 21.9, and 10.0 %, respectively. Process and treatment intensity/appropriateness indicators consistently improved. The proportion of patients with a Q score <15 decreased from 13.5 to 6.5 %, while those with a Q score >25 increased from 22.9 to 38.5 %.ConclusionsAMD Annals document the progress in quality of diabetes care. Longitudinal improvements in Q score can translate into less cardiovascular events, with evident clinical and economic implications. AMD Annals represent a physician-led effort not requiring allocation of extra-economic resources, which is easy to implement and deeply rooted in routine clinical practice. They are a potential case model for other healthcare systems.
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30 schema:keywords AMD Annals
31 AMD Annals continuous monitoring
32 AMD Annals continuous quality improvement initiative
33 Annals
34 Annals continuous monitoring
35 Annals continuous quality improvement initiative
36 ConclusionsAMD Annals
37 Italy
38 LDL cholesterol
39 allocation
40 appropriateness
41 appropriateness indicators
42 blood pressure
43 cardiovascular events
44 care
45 care indicators
46 care monitoring
47 care summary score
48 case model
49 cholesterol
50 clinic
51 clinical practice
52 continuous monitoring
53 continuous quality improvement initiative
54 design
55 diabetes
56 diabetes care
57 diabetes care indicators
58 diabetes clinic
59 dl
60 economic implications
61 efforts
62 electronic medical records
63 events
64 extra-economic resources
65 health policy
66 healthcare system
67 implications
68 improvement
69 improvement initiatives
70 indicators
71 initiatives
72 intensity/appropriateness
73 intensity/appropriateness indicators
74 intermediate outcome indicators
75 key strategy
76 less cardiovascular events
77 longitudinal improvement
78 medical records
79 methodsQuality
80 mmHg
81 model
82 monitoring
83 new cardiovascular events
84 outcome indicators
85 patients
86 physician-led effort
87 place
88 policy
89 potential case model
90 practice
91 pressure
92 previous studies
93 process
94 process indicators
95 progress
96 proportion
97 proportion of patients
98 quality
99 quality improvement initiatives
100 records
101 research design
102 resources
103 results
104 risk
105 routine clinical practice
106 scores
107 strategies
108 study
109 summary scores
110 system
111 treatment intensity/appropriateness
112 treatment intensity/appropriateness indicators
113 trends
114 type 2 diabetes
115 years
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