Management of diabetes in primary care: a structured-care approach.
Brennan, Carmel Harkins, Velma Perry, Ivan J
Brennan, Carmel
Harkins, Velma
Perry, Ivan J
Advisors
Editors
Other Contributors
Date
2008
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adolescent
Adult
Aged
Aged, 80 and over
Benchmarking
Blood Pressure
Cholesterol
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Female
Hemoglobin A, Glycosylated
Humans
Ireland
Male
Middle Aged
Outcome Assessment (Health Care)
Primary Health Care
Quality of Health Care
Retrospective Studies
Young Adult
Adult
Aged
Aged, 80 and over
Benchmarking
Blood Pressure
Cholesterol
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Female
Hemoglobin A, Glycosylated
Humans
Ireland
Male
Middle Aged
Outcome Assessment (Health Care)
Primary Health Care
Quality of Health Care
Retrospective Studies
Young Adult
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
In the Irish Midland Health Service Executive (HSE) Diabetes Structured Care Project, additional resources were targeted at general practice in the absence of a local hospital-based specialized diabetes unit.
We assessed the performance of the Midland HSE Diabetes Structured Care programme in 2003, bench-marked against Primary Care Trust (PCT) data from the 2003/2004 National Diabetes Audit for England.
Data on 947 patients (72% of eligible patients) from all 20 general practices participating in the structured-care programme were collected retrospectively over a 12-month period. The data included demographic and clinical variables as well as key process-of-care and intermediate outcome indicators used in the National Diabetes Audit for England.
The level of recording of process-of-care measures was near or above the upper quartile for PCTs in England. The proportion of patients with HbA(1c) concentrations at target levels (<6.5%) in the Midlands HSE project (26.8%) was virtually identical to the upper quartile level for PCTs in England (27.4%). The proportion of patients reaching target total cholesterol levels (<5.0 mmol/l) (54.6%) was close to the mean for PCTs in England (56.6%), and performance with regard to target blood pressure levels was equally poor in both the Midlands HSE (18.0%) and in PCTs in England (20.8%).
Primary-care-led structured care, with relatively limited but well-focused investment, can achieve quality of care for patients with diabetes, comparable to international best practice.
We assessed the performance of the Midland HSE Diabetes Structured Care programme in 2003, bench-marked against Primary Care Trust (PCT) data from the 2003/2004 National Diabetes Audit for England.
Data on 947 patients (72% of eligible patients) from all 20 general practices participating in the structured-care programme were collected retrospectively over a 12-month period. The data included demographic and clinical variables as well as key process-of-care and intermediate outcome indicators used in the National Diabetes Audit for England.
The level of recording of process-of-care measures was near or above the upper quartile for PCTs in England. The proportion of patients with HbA(1c) concentrations at target levels (<6.5%) in the Midlands HSE project (26.8%) was virtually identical to the upper quartile level for PCTs in England (27.4%). The proportion of patients reaching target total cholesterol levels (<5.0 mmol/l) (54.6%) was close to the mean for PCTs in England (56.6%), and performance with regard to target blood pressure levels was equally poor in both the Midlands HSE (18.0%) and in PCTs in England (20.8%).
Primary-care-led structured care, with relatively limited but well-focused investment, can achieve quality of care for patients with diabetes, comparable to international best practice.
Language
en
ISSN
1751-1402
eISSN
ISBN
DOI
10.1080/13814780802689154
PMID
22548297