Improved diabetes care by primary care physicians: results of a group-randomized evaluation of the Medicare Health Care Quality Improvement Program (HCQIP).
OBJECTIVE
Glycosylated hemoglobin (HbA1C) measurements in patients with diabetes mellitus contribute to glycemic control, and, therefore to lower diabetic complication rates. Determine if an intervention that includes claims-based feedback about patterns of HbA1C measurement results in more frequent monitoring of HbA1C in diabetic Medicare beneficiaries.


METHODS
Primary care physicians in a single Southern state treating Medicare beneficiaries with diabetes mellitus.


METHODS
A group-randomized evaluation of an intervention that included claims-based feedback about patterns of HbA1C measurement, educational materials, and practice aids.


RESULTS
Rates for each quality indicator increased from 1996 to 1998 for both the intervention and comparison groups, although increases were larger for intervention counties. HbA1C testing rates increased in intervention counties 16.8% compared to 13.0% in the comparison counties, an absolute difference of 4.0% (95% CI, 0.7 to 7.3). Differences for other indicators were small, although positive and favoring the intervention, and lacked statistical significance.


CONCLUSIONS
Physician interventions that included practice-level feedback about monitoring of glycemic control successfully led to improved care of diabetic Medicare beneficiaries.
McClellan
William M
WM
Georgia Medical Care Foundation, 1455 Lincoln Parkway, Suite 500, Atlanta, GA 30346, USA. BMCCLELL@gmcf.org
Millman
Lee
L
Presley
Rodney
R
Couzins
John
J
Flanders
W Dana
WD
D000368:Aged; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D005845:Georgia; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D006278:Medicare; D011320:Primary Health Care / Q000592:standards*; D011786:Quality Control; D011787:Quality of Health Care
D006442:Glycated Hemoglobin