Quality of diabetes care in Dutch care groups: no differences between diabetes patients with and without co-morbidity

Abstract

Objective: To evaluate the relationship between presence and nature of co-morbidity and quality of care for diabetes patients enrolled in diabetes disease management programmes provided by care groups. Methods:We performed an observational study within eight Dutch diabetes care groups. Data from patient record systems of care groups and patient questionnaires were used to determine quality of care. Quality of care was measured as provision of the recommended diabetes care, patients' achievement of recommended clinical outcomes and patients' perception of coordination and integration of care.Results: 527 diabetes patients without and 1187 diabetes patients with co-morbidity were included. Of the co-morbid patients, 7.8% had concordant co-morbid conditions only, 63.8% had discordant co-morbid diseases only and 28.4% had both types of conditions. Hardly any differences were observed between patients with and without co-morbidity in terms of provided care, achievement of clinical outcomes and perceived coordination and integration of care.Conclusions: Our study implies that care groups are able to provide similar quality of diabetes care for diabetes patients with and without co-morbidity. Considering the expected developments regarding additional disease management programmes in care groups, it is of importance to monitor quality of care, including patient experiences, for all chronic diseases. It will then become clear whether accountable provider-led organisations such as care groups are able to ensure quality of care for the increasing number of patients with multiple chronic conditions.

The development of integrated diabetes care in the Netherlands: a multiplayer self-assessment analysis

“…In general, disease management refers to a patient-centered approach that aims to improve, structure and coordinate delivery of health care services to a specific patient group [7]. In 2013, more than 80% percent of diabetes care in the Netherlands was delivered in primary care settings [8], including former secondary care such as delivering insulin therapy [9].…”

Predictors of Good Glycemic Control Among Type Ii Diabetes Patients in Palestine

“…The study instruments have been previously used by other studies [6][7][8][9][10][11][12][13][14][15][16].…”

“…The attending physician's specialty, details of preventive education, and feedback on patient perception of patient-professional interaction together with satisfaction with this interaction were obtained and measured and using a PPDCQ [8,9]. The physician's specialty was categorized as diabetologist or non-diabetologist.…”

Impact of the Prevalence of Concordant and Discordant Conditions on the Quality of Diabetes Care in Family Practices in England

“…5,8,9 The observation that the practice-level prevalence of diabetes is associated with a lower quality of process of care as measured by our composite indicator, although perhaps counterintuitive, is actually consistent with previous research. 9,28 This finding may be attributable to residual confounding on account of socioeconomic status of the practice population, which could also explain the similar patterns of associations observed in such conditions as epilepsy or mental health disorders, which tend to be more common in more deprived areas. 29,30 No association was observed between the prevalence of diabetes and intermediate outcomes, which might reflect that intermediate outcomes are the result of not only the medical care provided, but also of other factors, such as patients' adherence to medication and lifestyle recommendations.…”