title: Do Health Systems Have Consistent Performance Across Locations and Is Consistency Associated With Higher Performance?
abstract: This study addresses whether health systems have consistent diabetes care performance across their ambulatory clinics and whether increasing consistency is associated with improvements in clinic performance. Study data included 2007 to 2013 diabetes care intermediate outcome measures for 661 ambulatory clinics in Minnesota and bordering states. Health systems provided more consistent performance, as measured by the standard deviation of performance for clinics in a system, relative to propensity score-matched proxy systems created for comparison purposes. No evidence was found that improvements in consistency were associated with higher clinic performance. The combination of high performance and consistent care is likely to enhance a health system's brand reputation, allowing it to better mitigate the financial risks of consumers seeking care outside the organization. These results suggest that larger health systems are most likely to deliver the combination of consistent and high-performance care. Future research should explore the mechanisms that drive consistent care within health systems.
authors.affiliation: 1 University of Minnesota, Minneapolis, MN.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Crespin
authors.affiliation: 1 University of Minnesota, Minneapolis, MN.
authors.forename: Jon B
authors.initials: JB
authors.lastname: Christianson
authors.affiliation: 2 University of Michigan, Ann Arbor, MI.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: McCullough
authors.affiliation: 1 University of Minnesota, Minneapolis, MN.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Finch
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000592:standards; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards
keywords: consistency; diabetes; health systems; quality