title: Associations between technical quality of diabetes care and patient experience.
abstract: OBJECTIVE
  It has long been held that high-quality care has both technical and interpersonal aspects. The nature and strength of any association between both aspects remain poorly explored. This study investigated the associations between diabetes patients' reports of receiving recommended care (as measures of technical quality) and their experience and ratings (as measures of interpersonal care).
  
  
  METHODS
  Using data from a cross section of 3096 patients with diabetes nested within 24 diabetes-care-networks, we conducted multilevel regression analysis of the relationships between nine indicators of receiving care recommended in practice guidelines and: six scales of patient experience and global ratings of general practitioner, nurses, and overall diabetes care.
  
  
  RESULTS
  On average, reporting having received recommended care was associated with reporting better patient experience and ratings. The extent and frequencies of these associations varied across the different care processes. Receiving foot examination, physical activity advice, smoking status check, eye examination, and HbA1c testing, but not nutritional advice, urine, cholesterol or blood pressure checks, were statistically associated with better patient experience and global ratings. Those who received HbA1c testing rated their overall care 1.002 points higher (95% confidence interval: 0.726-1.278) on a scale of 0-10 than those who did not.
  
  
  CONCLUSIONS
  Higher self-reported technical quality of care in diabetes appears to be frequently but not always associated with better experiences and ratings. It is possible that the former leads to the latter and/or that both share a common cause within providers. Both care aspects do not seem interchangeable during performance assessment.
authors: Adjunct Faculty, Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the NetherlandsAssociate Professor, Department of Epidemiology, University of California, Los Angeles (UCLA), School of Public Health, Los Angeles, California, United States;Faculty Associate, Center for Health Policy Research, UCLA, Los Angeles, California, United States;Research fellow, Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands;Director, Center for Consumer Experience in Health Care, Utrecht, the Netherlands.Scientific Centre for Transformation in Care and Welfare (Tranzo), University of Tilburg, Tilburg, the Netherlands;Professor, Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the NetherlandsLead, Healthcare Quality Indicators Project, Organisation for Economic Cooperation and Development (OECD), Paris, FranceProfessor and Chair, Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors: Onyebuchi A
authors: OA
authors: Arah
authors: Bastiaan
authors: B
authors: Roset
authors: Diana M J
authors: DM
authors: Delnoij
authors: Niek S
authors: NS
authors: Klazinga
authors: Karien
authors: K
authors: Stronks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D055815:Young Adult