title: [Relationship between process indicators measured using electronic records and intermediate health outcomes in patients with diabetes].
abstract: OBJECTIVE
  To study relationship between institutional process indicators (measured using electronic records) and intermediate outcomes of patients with diabetes.
  
  
  METHODS
  Cross-sectional epidemiological study. Setting Primary care health district 1. Madrid. 2010.
  
  
  METHODS
  all patients with diabetes; n = 16.652. Main measures variables. Independent. Institutional process indicators. Dependent. Intermediate outcomes: GHb, BP, LDL, tobacco and weight within target limits and detected complications. Confounding. Age, gender, type and years for DM, co-morbidity, drugs and professional variables.
  
  
  RESULTS
  GHb of 55.9% (SE 0,4) of patients was within target limits. Bivariate analysis and multivariate logistic regression showed that the recording of some process indicators was associated with an increase in the probability to achieve targets in intermediate outcomes: reviewing personal and family history, lifestyle and drug therapy, creatinine, GHb, BP and weight measurement, smoking advice, EKG, ankle-arm index, and eye examination. OR were from 1,15 (CI 95%: 1.01-1.32) to 2.05 (CI 95%: 1.76-2.39). Relationship among other indicators and higher probability to achieve targets was not found: classification, reviewing care plan, glucose, BMI, LDL and microalbuminury measurement.
  
  
  CONCLUSIONS
  In diabetes, a lot of institutional process indicators measured on electronic records was associated with increase of probability to achieve targets in intermediate outcomes. It suggests to maintain process and outcome measurement, to include other outcomes, to include other interventions, to prioritize improvements in process indicators that show low performance and high impact and to keep out or to change process indicators that relationship was not found.
authors.affiliation: Área Única de Atención Primaria, Servicio Madrileño de Salud, Madrid, España. .gapm01@salud.madrid.org
authors.forename: G
authors.initials: G
authors.lastname: Garzón
authors.forename: A
authors.initials: A
authors.lastname: Gil
authors.forename: A
authors.initials: A
authors.lastname: Alvaro
authors.forename: R
authors.initials: R
authors.lastname: Rodrigo
authors.forename: M J
authors.initials: MJ
authors.lastname: Cerezo
authors.forename: C
authors.initials: C
authors.lastname: Domínguez
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*
keywords: Diabetes mellitus; Evaluación de proceso y de resultado; Outcome and process assessment; Records; Registros