Abstract:
BACKGROUND:In primary health care systems where member's turnover is relatively low, the question, whether investment in quality of care improvement can make a business case, or is cost effective, has not been fully answered.The objectives of this study were: (1) to investigate the relationship between improvement in selected measures of diabetes (type 2) care and patients' health outcomes; and (2) to estimate the association between improvement in performance and direct medical costs. METHODS:A time series study with three quality indicators - Hemoglobin A1c (HbA1c) testing, HbA1C and LDL- cholesterol (LDL-C) control - which were analyzed in patients with diabetes, insured by a large health fund. Health outcomes measures used: hospitalization days, Emergency Department (ED) visits and mortality. Poisson, GEE and Cox regression models were employed. Covariates: age, gender and socio-economic rank. RESULTS:96,553 adult (age >18) patients with diabetes were analyzed. The performance of the study indicators, significantly and steadily improved during the study period (2003-2009). Poor HbA1C (>9%) and inappropriate LDL-C control (>100 mg/dl) were significantly associated with number of hospitalization days. ED visits did not achieve statistical significance. Improvement in HbA1C control was associated with an annual average of 2% reduction in hospitalization days, leading to substantial reduction in tertiary costs. The Hazard ratio for mortality, associated with poor HbA1C and LDL-C, control was 1.78 and 1.17, respectively. CONCLUSION:Our study demonstrates the effect of continuous improvement in quality care indicators, on health outcomes and resource utilization, among patients with diabetes. These findings support the business case for quality, especially in healthcare systems with relatively low enrollee turnover, where providers, in the long term, could "harvest" their investments in improving quality.
journal_name
BMC Endocr Disordjournal_title
BMC endocrine disordersauthors
Wilf-Miron R,Bolotin A,Gordon N,Porath A,Peled Rdoi
10.1186/1472-6823-14-92subject
Has Abstractpub_date
2014-12-01 00:00:00pages
92issn
1472-6823pii
1472-6823-14-92journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Clinical determination of mid-parental height is an important part of the assessment of a child's growth, however our clinical impression has been that parents cannot be relied upon to accurately report their own heights. Therefore, we conducted this study to assess the accuracy of parental height self-repor...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-7-2
更新日期:2007-04-02 00:00:00
abstract:BACKGROUND:Lifestyle modification targeting weight management is the first-line treatment for women with Polycystic Ovary Syndrome (PCOS) regardless of presenting symptoms. Women with PCOS are more likely to gain more weight compared with women without PCOS, which may be related to barriers in engaging in lifestyle mod...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-019-0434-8
更新日期:2019-10-23 00:00:00
abstract:BACKGROUND:Self- management is vital to the control of diabetes. This study aims to assess the diabetes self-care behaviours of patients attending two tertiary hospitals in Gauteng, South Africa. The study also seeks to estimate the inequalities in adherence to diabetes self-care practices and associated factors. METH...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-0492-y
更新日期:2020-01-28 00:00:00
abstract:BACKGROUND:Early identification of children and adolescents with type 1 diabetes at high risk for development of complications is important, as early intervention may prevent further deterioration. Here we investigate the applicability of assessing skin advanced glycation end products (sAGEs) by skin autofluorescence (...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-016-0129-3
更新日期:2016-09-09 00:00:00
abstract::Hypopituitarism is deficiency of one or more pituitary hormones, of which adrenocorticotrophic hormone (ACTH) deficiency is the most serious and potentially life-threatening. It may occur in isolation or, more commonly as part of more widespread pituitary failure. Diagnosis requires demonstration of subnormal cortisol...
journal_title:BMC endocrine disorders
pub_type: 杂志文章,评审
doi:10.1186/s12902-016-0117-7
更新日期:2016-06-17 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) is a global health care problem that can impose a substantial economic burden. Diabetic peripheral neuropathy (DPN) is a common microvascular complication of DM that increases the potential for morbidity and disability due to ulceration and amputation. Though there is a significant amo...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-0534-5
更新日期:2020-04-15 00:00:00
abstract:BACKGROUND:We report a novel mutation within the StAR gene, causing congenital adrenal hyperplasia, with the so far unreported association with heterochromia iridis. CASE PRESENTATION:In a now 15-year-old girl (born at 41 + 6 weeks of gestation) adrenal failure was diagnosed in the neonatal period based on the clinica...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-019-0448-2
更新日期:2019-10-30 00:00:00
abstract:BACKGROUND:Most of the patients with type 1 and V hyperlipoproteinemia (HLP) present with symptoms and signs of acute pancreatitis due to marked elevation of triglycerides, but this baby presented with a chest infection, which was later diagnosed as type V HLP on laboratory workup. CASE PRESENTATION:We report a case o...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-0502-0
更新日期:2020-02-11 00:00:00
abstract:BACKGROUND:Promyelocytic leukaemia zinc finger (PLZF) is a transcriptional repressor that was originally isolated from a patient with promyelocytic leukaemia. PLZF also affects key elements for cell cycle progression, such as cyclin A, and can affect the tumourigenicity of various cancers. Thus far, the behaviour of PL...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-14-52
更新日期:2014-07-03 00:00:00
abstract:BACKGROUND:Benign thyroid nodules (BTN) are frequently diagnosed as papillary thyroid carcinoma (PTC), leading to unnecessary treatment. We found that plasma lncRNA DLG1-AS1 was upregulated in PTC patients but not in BTN patients and healthy controls. METHODS:In this study DLG1-AS1 and miR-199a-3p in plasma of both PT...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-019-0440-x
更新日期:2019-11-12 00:00:00
abstract:BACKGROUND:11 patients were referred to our Molecular Genetics Department at the Royal Devon and Exeter Hospital between 2000-2012 with a physician's diagnosis of remitting diabetes. Our aim was to identify patients with remitting diabetes whose clinical presentation is not explained by any known aetiology of diabetes....
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-14-45
更新日期:2014-06-09 00:00:00
abstract:BACKGROUND:The hormone somatostatin inhibits growth hormone release from the pituitary gland and is theoretically linked to diabetes and diabetes related complications. This study aimed to investigate the relationship between levels of the stable somatostatin precursor, N-terminal prosomatostatin (NT-proSST), with mort...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-015-0009-2
更新日期:2015-04-14 00:00:00
abstract:BACKGROUND:As an insulin-dependent disease, type 1 diabetes requires paying close attention to the glycemic control. Studies have shown that mobile health (mHealth) can improve the management of chronic diseases. However, the effectiveness of mHealth in controlling the glycemic control remains uncertain. The objective ...
journal_title:BMC endocrine disorders
pub_type: 杂志文章,meta分析
doi:10.1186/s12902-019-0347-6
更新日期:2019-02-13 00:00:00
abstract:BACKGROUND:We investigated the association between sleep symptoms, which cause sleep disorder, and quality of life (QoL) among people with type 2 diabetes (T2D). METHODS:In this cross-sectional study of 342 people with T2D, the Japan National Health and Wellness Survey (NHWS) database 2016 were used. We treated the re...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-00579-4
更新日期:2020-06-30 00:00:00
abstract:BACKGROUND:Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is caused by tumours releasing ACTH. Ectopic ACTH-producing tumour regression is rarely induced using steroidogenesis inhibitors. We presented a case of EAS in which ACTH production by a lung tumour was reduced by metyrapone (MTP) and also reviewed pr...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-018-0246-2
更新日期:2018-03-27 00:00:00
abstract:BACKGROUND:Medullary thyroid carcinoma is a malignant uncommon and aggressive tumour of the parafollicular C cells. In about 75% of cases it is sporadic while, in case of RET mutation, it is associated to multiple endocrine neoplasia type 2 (25% of cases). The biochemical features of medullary thyroid carcinoma include...
journal_title:BMC endocrine disorders
pub_type: 杂志文章,评审
doi:10.1186/s12902-019-0435-7
更新日期:2019-10-16 00:00:00
abstract:BACKGROUND:This study aimed to measure the effect of diabetes education using the novel method of "diabetes conversation map (DCM)" as compared to routine counselling (RC) on diabetes management self-efficacy (DMSE) among patients living with type 2 diabetes in Karachi, Pakistan. METHODS:A parallel arm randomized cont...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-00572-x
更新日期:2020-06-16 00:00:00
abstract:UNLABELLED: BACKGROUND:Hypoglycaemia is a serious adverse effect of antidiabetic drug therapy. We aimed to determine incidence rates of hypoglycaemia in type-2 diabetic patients and identify predictors of hypoglycaemia when treatment is intensified. METHODS:DiaRegis is a prospective German registry that follows 3810 ...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-12-23
更新日期:2012-10-17 00:00:00
abstract:BACKGROUND:The aim of the present study is to evaluate the association between BMD and type 2 DM status in middle-aged and elderly men. To investigate a possible correlation, the present study used the BMD dataset of the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011. METHODS:In tot...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-018-0290-y
更新日期:2018-09-05 00:00:00
abstract:BACKGROUND:A growing body of evidence supports neutrophils as having an active role in the development of diabetic kidney disease (DKD). However, the clinical relevance of neutrophils and DKD in autoimmune diabetes remains unknown. This study aimed to investigate the relationship between circulating neutrophils and DKD...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-00597-2
更新日期:2020-10-22 00:00:00
abstract:BACKGROUND:The association between thyroid nodules and adiposity remains controversial. We performed a cross-sectional, community-based study to examine whether thyroid nodules are associated with overweight and obesity, as defined with body mass index (BMI) and waist circumference. METHODS:The study included 1482 sub...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-018-0232-8
更新日期:2018-01-27 00:00:00
abstract:BACKGROUND:Spontaneous haemorrhage into a parathyroid adenoma is a rare and potentially life-threatening presentation. CASE PRESENTATION:We report the case of a 45 year old female recently diagnosed with primary hyperparathyroidism who presented with chest discomfort and acute airway compromise due to spontaneous extr...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-017-0186-2
更新日期:2017-06-21 00:00:00
abstract:BACKGROUND:Hyperglycemia induces chromatin remodeling with consequences on differential gene expression in mouse hepatocytes, similar to what occurs during aging. The liver is the central organ for the regulation of glucose homeostasis and xenobiotic and lipid metabolism and is affected by insulin signaling. The precis...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-14-19
更新日期:2014-03-03 00:00:00
abstract:BACKGROUND:Telomeres are DNA repeat sequences necessary for DNA replication which shorten at cell division at a rate directly related to levels of oxidative stress. Critical telomere shortening predisposes to cell senescence and to epithelial malignancies. Type 2 diabetes is characterised by increased oxidative DNA dam...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-8-12
更新日期:2008-10-10 00:00:00
abstract:BACKGROUND:The objective was to examine how the indigenous naming, indigenous self-diagnosis and management of diabetes evolved with awareness in order to develop a socially oriented theoretical model for its care. METHODS:The data was collected through a one-year extended participant observation in Bafut, a rural hea...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-9-5
更新日期:2009-02-19 00:00:00
abstract:BACKGROUND:Insulin resistance and diabetes are associated with increased oxidative stress and impairment of cellular defence systems. Our purpose was to investigate the interaction between glucose metabolism, antioxidative capacity and heat shock protein (HSP) defence in different skeletal muscle phenotypes among middl...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-8-3
更新日期:2008-03-27 00:00:00
abstract:AIM:To assess the factors associated with antihyperglycaemic medication initiation in UK patients with newly diagnosed type 2 diabetes. METHODS:In a retrospective cohort study, patients with newly diagnosed type 2 diabetes were identified during the index period of 2003-2005. Eligible patients were ≥ 30 years old at t...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-12-1
更新日期:2012-03-07 00:00:00
abstract:BACKGROUND:Sirtuin 1 (SIRT1) and sirtuin 3 (SIRT3) proteins have an important role in counteracting oxidative stress. Although diabetes and hypothyroidism (HT) are both characterized by oxidative stress, the mechanisms are not fully understood. This study investigated the effects of type 1 diabetes (T1D), type 2 diabet...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-019-0350-y
更新日期:2019-02-08 00:00:00
abstract:BACKGROUND:Radioisotope scanning is important to diagnose subacute thyroiditis (SAT), but it's not always available. So we aim to establish a diagnostic scale for SAT without radioisotope scanning. METHODS:The suspected SAT patients hospitalized in Yuebei people's Hospital from January 2012 to December 2016 were selec...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/s12902-020-00554-z
更新日期:2020-05-27 00:00:00
abstract:BACKGROUND:The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all tha...
journal_title:BMC endocrine disorders
pub_type: 杂志文章
doi:10.1186/1472-6823-9-13
更新日期:2009-05-09 00:00:00