title: Quality of outpatient care for diabetes mellitus in a national electronic health record network.
abstract: This retrospective cohort study examined quality of care for diabetes in a large national network of electronic health record users. Of 10572 patients with diabetes included in the study, 55% had at least 2 hemoglobin A1c (HbA1c) tests, 95% had at least 1 systolic and diastolic blood pressure test, and 52% had at least 1 low-density lipoprotein (LDL) cholesterol test over a 1-year period. Of those tested, 41% had an HbA1c<7.0, 28% had a blood pressure<130/80 mm Hg, and 44% had an LDL cholesterol level<100 mg/dL. Of those not adequately controlled, 99% were prescribed hypoglycemic medications, 85% were prescribed antihypertensive medications, and 71% were prescribed lipid-lowering medications. These results suggest that there is significant room for improvement in testing and control of risk factors for persons with diabetes and that the electronic health record has a significant potential for conducting practice-based quality-of-care studies across large numbers of outpatient practices.
authors.affiliation: Christiana Care Health System, Family and Community Medicine, Wilmington, DE, USA. gillj@dvoresearch.com
authors.forename: James M
authors.initials: JM
authors.lastname: Gill
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Foy
authors.forename: Yu
authors.initials: Y
authors.lastname: Ling
mesh_terms: D000553:Ambulatory Care / Q000592:standards*; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D011787:Quality of Health Care; D012189:Retrospective Studies; D014481:United States