Provider organization performance assessment utilizing diabetes physician recognition program.
OBJECTIVE
To examine the level of care in a large provider organization with respect to the Diabetes Physician Recognition Program (DPRP) standards of care and describe treatment patterns, diabetes-related complications, and achievement of clinical goals among patients stratified by glycemic control levels.


METHODS
Observational, retrospective, chart review study assessing care among patients with diabetes.


METHODS
Diabetic patients aged > or =5 years who were prescribed insulin or oral hypoglycemics/antihyperglycemics for at least 12 months by 1 of 14 DPRP-participating physicians from the provider organization were eligible. A sample of patient medical charts was collected. Descriptive statistics were generated to assess demographic and clinical variables, with subanalyses for patients in the 3 glycosylated hemoglobin (A1C) cohorts. Data were used to describe the demographics, disease prevalence, comorbidities, clinical outcomes, and treatment patterns of the study population. Results were assessed according to national treatment guidelines.


RESULTS
Almost all DPRP recognition measures were met and/or exceeded. More than 90% of patients received appropriate assessments. The majority achieved the A1C, blood pressure, and low-density lipoprotein control levels recommended by national treatment guidelines. Patients with multiple comorbidities had worse levels of control, with only 14.3% of patients achieving all 3 treatment goals. Nearly 30% of patients had diabetes-related complications, most commonly kidney disease.


CONCLUSIONS
Differences in control and treatment patterns exist in patients with varying levels of glycemic control. Opportunities exist to improve diabetes care through goal attainment. Further research is needed to determine whether specific measures of care correlate with levels of glycemic control.
Wall
Bruce
B
The Medical Group of Ohio, 445 Hutchinson Ave, Ste 950, Columbus, OH 43235-5677, USA. bhumphrey@themgo.com
Chiao
Evelyn
E
Plauschinat
Craig A
CA
Miner
Paul A
PA
Jackson
James H
JH
Humphrey
Benjamin
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000191:economics; D005260:Female; D006302:Health Services Research; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies
D007004:Hypoglycemic Agents