Navigation Links
Quality Improvement Effort Pays Off in Diabetes Care

Spending money to improve diabetes care at federally qualified community health centers is a sound investment, according to one of the first studies to examine the clinical and economic impact of quality improvement on diabetes care.

In the June 2007 issue of Health Services Research, a University of Chicago-based research team reports that a relatively inexpensive national effort to improve the process of care at selected clinics was able to make enough difference in its first four years that, if sustained, it could reduce patients' lifetime risk of blindness, end-stage kidney disease and coronary artery diseaseall common complications of diabetes.

At a cost of less than $500 per patient each year, this modest quality improvement effort is projected to reduce the incidence of major complications, such as end-stage renal disease, which can cost $44,000 per patient each year.

"In this setting, we found that the economic value of improving the delivery of existing diabetes care was roughly equal to the benefits of developing a new treatment, such as a novel diagnostic technology or a better drug," said study author Elbert Huang, MD, assistant professor of medicine at the University of Chicago. "A small investment in upgrading the delivery of health care brought about a substantial improvement in health that justified the costs of the program."

"Unfortunately," he added, "the people who make such financial investments are not the people who directly benefit from them."

Federally qualified community health centers (FQHCs) routinely lose money on health care improvement programs. The added costs are borne by the health centers and by state and federal government programs; the benefits accrue to society. "Cost-effective medicine," Huang said, "depends entirely on an ongoing societal commitment to providing chronic care for vulnerable patients."

The researchers studied how diabetes care ch anged at 17 Midwestern FQHCs that participated in the Health Disparities Collaborativesa national, federally funded quality-improvement initiative launched in 1998.

The program was designed to make certain that patients at these FQHCs, which provide primary care services in underserved urban and rural communities, received the current standard of care. This includes regular testing for glycosylated hemoglobin (a measure of blood sugar control), assessment of fats and cholesterol in the blood, eye exams and blood pressure checks, with appropriate follow-up. It also involves preventive treatments such as the use of ACE inhibitors, which can treat high blood pressure and heart failure, and aspirin, which can prevent heart attacks and strokes.

After reviewing four years of charts for 80 patients from each of the 17 centers, the researchers reported that "multiple components of care improved from 1998 to 2002." Annual glycosylated hemoglobin testing increased from 71 percent to 92 percent of patients. Blood lipid testing rose from 15 percent to 44 percent. Eye exams went from 25 percent to 44 percent. Prescriptions for ACE inhibitors rose from 33 percent of patients to 55 percent, and aspirin prescriptions rose from 22 percent to 45 percent.

These improvements added very little expense. The diabetes quality-improvement program cost about $700 per patient the first year, $600 the second year, $500 the third year and leveled off at $378 per year beginning in year four.

The researchers then estimated how much the patients' risk for the major complications from diabetes would be decreased if these improvements were maintained. Better care, they concluded, should reduce the lifetime incidence of blindness from 17 percent of patients down to 15 percent, of kidney failure from 18 down to 15 percent and of coronary artery disease from 28 to 24 percent.

Next they tried to place a dollar value on the benefits of the programa longer life with fewer complications. In medical cost-effectiveness analysis, a commonly accepted standard is to say that a new device, medication or program that generates one year of extra life for a healthy person at less than $100,000 is a good value. Another commonly used standard is $50,000 per one year of extra life in perfect health.

The diabetes quality-improvement initiative passed all these standards. Even at twice the price and with the benefits deeply discounted, the value added by the program exceeded commonly accepted standards.

"Since diabetes is so common and is increasing rapidly, whatever enhances diabetes care is worth looking at," Huang said.

A study released last month at the American Association of Clinical Endocrinologists' annual meeting in Seattle found that poorly managed type 2 diabetes costs the U.S. health system an extra $22.9 billion a year in direct medical costs. Diabetic complications cost almost $10,000 per patient each year, concluded the author of that study, Willard Manning, PhD, a University of Chicago health economist.

Multiple quality-improvement programs have been found to produce improvements similar to those generated by the Health Disparities Collaboratives' diabetes program, Huang said, but "the economic value of these programs is generally unknown." The lessons learned from this evaluation, he added, "can provide important insights for policy makers."


'"/>




Related medicine news :

1. Quality of life after cancer
2. Steps To Improve Quality Of Plant-Based Drugs
3. Quality of lives of older people
4. Life Quality For Patients With Multiple Sclerosis
5. Relationship Between Genetic Structure And Quality of Life
6. Poorer Quality of Life Observed In Overweight Kids
7. Childhood Obesity May Influence The Their Quality Of Life
8. Indian Hospitals – A Destination For Quality Medical Care
9. The Growing Rise In Clinical Research Could Lead To A Compromise In Quality Of Research And Ethics
10. Quality Awareness In Hospitals Can Reduce Mortality Rate Of Patients
11. Data On Quality Of Health Care Can Be Easily Obtained
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:10/12/2017)... ... October 12, 2017 , ... ... the demand of today’s consumer and regulatory authorities worldwide. From Children’s to Adults ... tested to meet the highest standard. , These products are also: Gluten ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... leader in post-acute health care, have expanded their existing home health joint venture ... , AccentCare has been operating a joint venture home health company with Asante, ...
(Date:10/12/2017)... ... October 12, 2017 , ... HMP , a leader in healthcare events ... Magazine Eddie Digital Award for ‘Best B-to-B Healthcare Website.’ Winners were announced during the ... The annual award competition recognizes editorial and design excellence across a range of sectors. ...
(Date:10/12/2017)... ... October 12, 2017 , ... Women-owned ... Michigan’s 2017 Best and Brightest in Wellness® by Best and Brightest. OnSite Wellness ... on Friday, Oct. 20 from 7:30 a.m. to 2 p.m. at the Henry ...
(Date:10/12/2017)... ... 12, 2017 , ... Vohra Chief Medical Officer Dr. Shark ... skilled nursing facility medical directors and other clinicians at various events in October. ... "At many of these conferences we get to educate other physicians, facility nurses, ...
Breaking Medicine News(10 mins):
(Date:9/27/2017)... Sept. 27, 2017  Commended for their devotion to personalized ... Ranked as number one in the South Florida Business Journal,s ... Inc. 5000 yearly list, the national specialty pharmacy has found ... Bardisa will soon be honored by SFBJ as the ... Set to receive his award in October, Bardisa ...
(Date:9/25/2017)...   Montrium , an industry leader in ... IQPC Trial Master Files & Inspection Readiness Conference ... Clinical Services has selected eTMF Connect ... EastHORN, a leading European contract research organization (CRO), ... to enable greater collaboration with sponsors, improve compliance ...
(Date:9/23/2017)... , Sept. 22, 2017 Janssen Biotech, Inc. ... response letter from the U.S. Food and Drug Administration ... of sirukumab for the treatment of moderately to severely ... additional clinical data are needed to further evaluate the ... severely active RA. ...
Breaking Medicine Technology: