title: Care planning and adherence to diabetes process guidelines: medicare data analysis.
abstract: OBJECTIVE
  To test the association, in patients with a diagnosis of diabetes I and II, between having or not having a care plan, (i.e. General Practice Management Plans (GPMPs),Team Care Arrangements (TCAs)), and having the recommended number of biochemical checks according to the diabetes Annual Cycle of Care guideline. The checks comprised HbA1c, HDL cholesterol and urinary microalbumin.
  
  
  METHODS
  Chi-square analysis of retrospective group data obtained from the Medicare database (from 'billing' patterns only).
  
  
  RESULTS
  The creation of GPMPs was associated with general practitioners (GPs) requesting checks for HbA1c (59.7%), HDL cholesterol (36.9%) and microalbumin (50.8%) for diabetes patients in accordance with guideline recommendations. Although the introduction of multidisciplinary care via a TCA was associated with an increase in the frequency of HbA1c checks (61.3%) in accordance with the guidelines, there was a reduction in the number of HDL cholesterol (23.7%) and microalbumin (36.8%) checks. The group with no care plans had the lowest association with HbA1c (47.8%), HDL cholesterol (19.7%) and microalbumin (29.3%) checks that met guideline requirements for diabetes.
  
  
  CONCLUSIONS
  The use of GPMPs showed strong association with increased testing of process measures that met guideline requirements for diabetes. Further research is needed to understand the value and benefits of TCAs in promoting adherence to diabetes guidelines.
authors.affiliation: Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia. akuh.adaji@monash.edu
authors.forename: Akuh
authors.initials: A
authors.lastname: Adaji
authors.forename: Peter
authors.initials: P
authors.lastname: Schattner
authors.forename: Kay Margaret
authors.initials: KM
authors.lastname: Jones
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Beovich
authors.forename: Leon
authors.initials: L
authors.lastname: Piterman
mesh_terms: D001315:Australia; D016009:Chi-Square Distribution; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D010346:Patient Care Management / Q000379:methods* / Q000706:statistics & numerical data; D010347:Patient Care Planning; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012189:Retrospective Studies