title: Impact of a chronic care coordinator intervention on diabetes quality of care in a community health center.
abstract: OBJECTIVE
  To evaluate the impact of a clinic-based chronic care coordinator (CCC) intervention on quality of diabetes care, health outcomes and health service utilization within six community health centers serving predominantly low-income Hispanic and non-Hispanic white patients.
  
  
  METHODS
  We used a retrospective cohort study design with a 12-month pre- and 12-month postintervention analysis to evaluate the effect of the CCC intervention and examined: (1) the frequency of testing for glycated hemoglobin (HbAIC), cholesterol LDL level, and microalbumin screen and frequency of retinal and foot exam; (2) outcomes for HbAIC levels, lipid, and blood pressure control; and (3) health care service utilization. Patients with diabetes who received the CCC intervention (n = 329) were compared to a propensity score adjusted control group who are not exposed to the CCC intervention (n = 329). All of the data came from Electronic Medical Record. Four separate sets of analyses were conducted to demonstrate the effect of propensity score matching on results.
  
  
  RESULTS
  The CCC intervention led to improvements in process measures, including more laboratory checks for HbAIC levels, microalbuminuria screens, retinal and foot exams and also increased primary care visits. However, the intervention did not improve metabolic control.
  
  
  CONCLUSIONS
  CCC interventions offer promise in improving process measures within community health centers but need to be modified to improve metabolic control.
authors.affiliation: Department of Health Services, University of WA School of Public Health, Seattle, WA.
authors.forename: Rosa
authors.initials: R
authors.lastname: Solorio
authors.affiliation: Center for Biomedical Statistics, University of WA School of Public Health, Seattle, WA.
authors.forename: Aasthaa
authors.initials: A
authors.lastname: Bansal
authors.affiliation: Center for Biomedical Statistics, University of WA School of Public Health, Seattle, WA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Comstock
authors.affiliation: Department of Health Services, University of WA School of Public Health, Seattle, WA.
authors.forename: Krista
authors.initials: K
authors.lastname: Ulatowski
authors.affiliation: Sea Mar Community Health Centers, Seattle, WA.
authors.forename: Sara
authors.initials: S
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood; D002908:Chronic Disease; D003151:Community Health Centers / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006630:Hispanic or Latino; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010346:Patient Care Management / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration; D011204:Poverty Areas; D011320:Primary Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D012648:Self Care; D044465:White People
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin
keywords: Diabetes; Hispanic; chronic care coordinators