title: Quality of care and relative resource use for patients with diabetes.
abstract: OBJECTIVE
  To investigate the relationship between quality of care and relative resource use for patients with diabetes enrolled in commercial insurance plans.
  
  
  METHODS
  Retrospective cohort study employing data from the Healthcare Effectiveness Data and Information Set for 2009 to 2011.
  
  
  METHODS
  Correlations between quality of care and various relative resource use measures are estimated. In addition to overall estimates, the sample is disaggregated by year, plan type, and geographic region. Correlations are also estimated for year-to-year changes in quality and relative resource use.
  
  
  RESULTS
  The overall results are generally consistent with previous findings regarding the relationship between quality of care and relative resource use. However, the disaggregated results indicate nuanced associations; for instance, the relationship appears to vary by year. Also, while there is a positive relationship between quality and evaluation and management services for preferred provider organizations, the relationship is negative for the other 2 plan types studied. The analysis of year-to-year changes indicates that changes in quality are negatively related to inpatient costs.
  
  
  CONCLUSIONS
  The findings suggest, given that quality and relative resource use are not necessarily positively related, that it may be possible to improve diabetes care quality at minimal cost. However, the disaggregated results suggest that the potential to increase quality can vary significantly by resource type, plan type, and geographic region. Thus, the most effective policies to improve quality may vary by plan.
authors.affiliation: University of South Florida, Department of Health Policy and Management, 12901 Bruce B. Downs Blvd, Tampa, FL 33612. E-mail: troyquast@health.usf.edu.
authors.forename: Troy
authors.initials: T
authors.lastname: Quast
mesh_terms: D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D011787:Quality of Health Care; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology