Effect of quality improvement organization activities on outpatient diabetes care in eastern New York State.

Abstract:

BACKGROUND:Quality improvement organizations (QIOs) are contracted to improve the quality of care delivered to Medicare beneficiaries. The purpose of this study was to determine whether provider participation in New York State QIO activities resulted in significant improvements in the quality of diabetes care during the recent contract cycle with the Centers for Medicare & Medicaid Services. RESEARCH DESIGN:A retrospective analysis between participating and nonparticipating providers on their performance in 3 quality measures (biennial ophthalmology examination, biennial lipid profile monitoring, annual hemoglobin A1c monitoring) was used. Data of New York State Medicare beneficiaries before and after QIO intervention activities were examined to determine change in performance. General linear models were created to examine the effect QIO participation had on the change in performance for each measure. RESULTS:Providers who participated in QIO activities had significant absolute improvements in lipid monitoring compared with nonparticipating providers at high baseline performance for low (3.10%, P < 0.001), medium (2.57%, P < 0.001), and high (1.51%, P = 0.002) baseline patient volume, and medium baseline performance for low (2.38%, P < 0.001), and medium (1.85%, P < 0.001) baseline patient volume. The same trend was seen for hemoglobin A1c monitoring (4.28%, P < 0.001; 3.57%, P < 0.001; 2.15%, P < 0.001; 2.63%, P = 0.001; 1.92%, P = 0.006). For ophthalmology examination, participation resulted in significant changes at low (2.28%, P = 0.003) and medium (1.73%, P = 0.009) baseline patient volume. CONCLUSION:The study results suggest QIO activities can improve outpatient diabetes care; however, limitations in the study design preclude any definitive remarks.

journal_name

Med Care

journal_title

Medical care

authors

Wu WY,Chen JJ,Shih A

doi

10.1097/01.mlr.0000237420.30406.ea

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

1142-7

issue

12

eissn

0025-7079

issn

1537-1948

pii

00005650-200612000-00013

journal_volume

44

pub_type

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