title: Quality of primary care processes for individuals with chronic diseases associated with the metabolic syndrome: a comparative study.
abstract: OBJECTIVE
  The aim of this study is to investigate whether individuals diagnosed with chronic diseases associated with the metabolic syndrome (MetS) receive favorable quality of care processes in the primary care setting relative to other individuals with and without chronic diseases.
  
  
  BACKGROUND
  Data from the 2010 Brazos Valley Health Status Assessment (BVHSA) (n = 3964) were analyzed. Individuals diagnosed with chronic diseases that are collectively associated with a diagnosis of MetS, namely obesity, diabetes, high cholesterol, and hypertension, were characterized as a group (ie, analytic sample, n = 168). Clinical guidelines were utilized to identify indicators representing the quality of care processes received by these individuals during visits with their health-care provider.
  
  
  METHODS
  Measures of quality of care processes were analyzed relative to a comparator group comprising individuals with no chronic diseases and an alternative test group comprising those diagnosed with other chronic diseases (eg, arthritis, depression, and cancer among others) using multinomial and binary logistic regression.
  
  
  RESULTS
  Physician communication of critical issues such as diet, stress, and weight status was statistically more pronounced in the analytic sample relative to the comparator group. However, differences in physician communication about physical activity were not statistically significant relative to the comparator group (OR = 1.26, P = 0.533). Differences in testing of cholesterol (OR = 0.94, P = 0.743) and blood pressure (OR = 1.16, P = 0.619) were also not statistically significant relative to the comparator group. Individuals who may have MetS generally receive favorable quality of care processes from their health-care provider, but opportunities exist to enhance provider communication about physical activity, and to possibly improve frequency of cholesterol and blood pressure testing.
authors.affiliation: Department of Health Policy & Management, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX 77843, USA. dickerson@srph.tamhsc.edu
authors.forename: Justin B
authors.initials: JB
authors.lastname: Dickerson
authors.forename: Matthew Lee
authors.initials: ML
authors.lastname: Smith
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: McNeal
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D016017:Odds Ratio; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D013223:Statistics as Topic; D013781:Texas / Q000453:epidemiology