Use of an electronic integral monitoring system for patients with diabetes to identify factors associated with an adequate glycemic goal and to measure quality of care

2021 ◽  
Vol 15 (1) ◽  
pp. 162-168
Author(s):  
Neftali Eduardo Antonio-Villa ◽  
B. Geovani Palma-Moreno ◽  
Fátima M. Rodríguez-Dávila ◽  
Francisco J. Gómez-Pérez ◽  
Carlos A. Aguilar-Salinas ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Monitoring System ◽  
Factors Associated ◽  
Patients With Diabetes

scholarly journals Factors associated with quality of care for patients with pancreatic cancer in Australia

2016 ◽  
Vol 205 (10) ◽  
pp. 459-465 ◽  
Author(s):  
Elizabeth A Burmeister ◽  
Dianne L O'Connell ◽  
Susan J Jordan ◽  
David Goldstein ◽  
Neil Merrett ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Quality Of Care ◽  
Factors Associated

scholarly journals Quality of care for patients with diabetes mellitus type 2 in ‘model practices’ in Slovenia – first results

2016 ◽  
Vol 55 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Davorina Petek ◽  
Mitja Mlakar
Keyword(s):  
Diabetes Mellitus ◽  
Quality Of Care ◽  
Quality Indicators ◽  
Diabetes Mellitus Type 2 ◽  
Process Quality ◽  
Diabetes Mellitus Type ◽  
Before And After ◽  
Patients With Diabetes

Abstract Background A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone. The aim of the study is to compare the quality of management of patients with diabetes mellitus type 2 before and after the introduction of model practices. Methods A cohort retrospective study was based on medical records from three practices. Process quality indicators, such as regularity of HbA1c measurement, blood pressure measurement, foot exam, referral to eye exam, performance of yearly laboratory tests and HbA1c level before and after the introduction of model practices were compared. Results The final sample consisted of 132 patients, whose diabetes care was exclusively performed at the primary care level. The process of care has significantly improved after the delivery of model practices. The most outstanding is the increase of foot exam and HbA1c testing. We could not prove better glycaemic control (p>0.1). Nevertheless, the proposed benchmark for the suggested quality process and outcome indicators were mostly exceeded in this cohort. Conclusion The introduction of a nurse into the team improves the process quality of care. Benchmarks for quality indicators are obtainable. Better outcomes of care need further confirmation.

scholarly journals Thirty-day readmission rate as a surrogate marker for quality of care in neurosurgical patients: a single-center Canadian experience

2019 ◽  
Vol 130 (5) ◽  
pp. 1692-1698 ◽  
Author(s):  
Mitchell P. Wilson ◽  
Andrew S. Jack ◽  
Andrew Nataraj ◽  
Michael Chow
Keyword(s):  
Multivariate Analysis ◽  
Quality Of Care ◽  
Readmission Rate ◽  
Univariate Analysis ◽  
Surrogate Marker ◽  
Readmission Rates ◽  
Factors Associated ◽  
Neurosurgical Patients ◽  
Avoidable Readmissions

OBJECTIVEReadmission to the hospital within 30 days of discharge is used as a surrogate marker for quality and value of care in the United States (US) healthcare system. Concern exists regarding the value of 30-day readmission as a quality of care metric in neurosurgical patients. Few studies have assessed 30-day readmission rates in neurosurgical patients outside the US. The authors performed a retrospective review of all adult neurosurgical patients admitted to a single Canadian neurosurgical academic center and who were discharged to home to assess for the all-cause 30-day readmission rate, unplanned 30-day readmission rate, and avoidable 30-day readmission rate.METHODSA retrospective review was performed assessing 30-day readmission rates after discharge to home in all neurosurgical patients admitted to a single academic neurosurgical center from January 1, 2011, to December 31, 2011. The primary outcomes included rates of all-cause, unplanned, and avoidable readmissions within 30 days of discharge. Secondary outcomes included factors associated with unplanned and avoidable 30-day readmissions.RESULTSA total of 184 of 950 patients (19.4%) were readmitted to the hospital within 30 days of discharge. One-hundred three patients (10.8%) were readmitted for an unplanned reason and 81 (8.5%) were readmitted for a planned or rescheduled operation. Only 19 readmissions (10%) were for a potentially avoidable reason. Univariate analysis identified factors associated with readmission for a complication or persistent/worsening symptom, including age (p = 0.009), length of stay (p = 0.007), general neurosurgery diagnosis (p < 0.001), cranial pathology (p < 0.001), intensive care unit (ICU) admission (p < 0.001), number of initial admission operations (p = 0.01), and shunt procedures (p < 0.001). Multivariate analysis identified predictive factors of readmission, including diagnosis (p = 0.002, OR 2.4, 95% CI 1.4–5.3), cranial pathology (p = 0.002, OR 2.7, 95% CI 1.4–5.3), ICU admission (p = 0.004, OR 2.4, 95% CI 1.3–4.2), and number of first admission operations (p = 0.01, OR 0.51, 95% CI 0.3–0.87). Univariate analysis performed to identify factors associated with potentially avoidable readmissions included length of stay (p = 0.03), diagnosis (p < 0.001), cranial pathology (p = 0.02), and shunt procedures (p < 0.001). Multivariate analysis identified only shunt procedures as a predictive factor for avoidable readmission (p = 0.02, OR 5.6, 95% CI 1.4–22.8).CONCLUSIONSAlmost one-fifth of neurosurgical patients were readmitted within 30 days of discharge. However, only about half of these patients were admitted for an unplanned reason, and only 10% of all readmissions were potentially avoidable. This study demonstrates unique challenges encountered in a publicly funded healthcare setting and supports the growing literature suggesting 30-day readmission rates may serve as an inappropriate quality of care metric in neurosurgical patients. Potentially avoidable readmissions can be predicted, and further research assessing predictors of avoidable readmissions is warranted.

Adults’ use of electronic communication (e-communication) with providers: Evidence on the prevalence, factors, and its effect on perceived quality of care from the HINTS survey (Preprint)

2021 ◽  
Author(s):  
Rumei Yang ◽  
Kai Zeng ◽  
Yun Jiang
Keyword(s):  
Quality Of Care ◽  
Rural Area ◽  
Perceived Quality ◽  
Self Report ◽  
Current Status ◽  
Patient Portal ◽  
Provider Communication ◽  
Factors Associated ◽  
Perceived Quality Of Care

BACKGROUND Effective patient-provider communication is the core of high-quality patient-centered care. Communication through electronic platforms such as web, patient portal, or mobile phone (referring as e-communication) has become increasingly important as it extends traditional in-person communication with less limitation of timing and locations, and has the potential to facilitate more effective interactions between patients and providers. However, little is known about the current status of patients’ use of e-communication with healthcare providers and whether the use is related to better perceived quality of care at the population level. OBJECTIVE This study was designed to explore the prevalence of, and factors associated with e-communication and effect of e-communication on patient perceived quality of care, using the nationally representative sample of the 2019 Health Information National Trends Survey 5 (HINTS 5)-Cycle 3. METHODS Data from 5,438 survey responders aged 18 years+ (mean=49.04 years, range=18-98) were included in the analysis. All variables were measured using self-report surveys. Logistic and linear regression analyses were used to explore responders’ profile characteristics related to use of e-communication and that use related quality of care. Descriptive sub-analyses for e-communication according to age groups were also performed. All analyses considered the complex design using the jackknife replication method. RESULTS The overall prevalence of the use of e-communication was 60%, with the lowest prevalence in older adults aged 65 years or above (17%), significantly lower than adults younger than 45 years old (41%) and adults aged between 45-65 years (42%) (p<.001). American adults who had some college (OR=3.14, 95% CI 1.52–6.48, p=.003) or college graduate+ (OR=4.14, 95% CI 2.04–8.39, p<.001), household income at or greater than $50,000 (OR=1.75, 95% CI 1.25–2.46, p=.002), or a regular provider (OR=1.93, 95% CI 1.43–2.61, p<.001) were more likely to use e-communication. In contrast, those who reside in rural area (OR=0.59, 95% CI 0.39–0.89, p=.014) were less likely to use e-communication. After controlling for demographic (e.g., age, gender, education, income, and comorbidity) and relationship factors (e.g., regular provider, communication quality, and trust a doctor), the use of e-communication was statistically significantly associated with better quality of care (β=0.13, 95% CI 0.01-0.25, p=.039). CONCLUSIONS Our findings on factors associated with e-communication and the positive association between e-communication and quality of care suggest that policy-level attention is needed to engage the socially disadvantaged (i.e., those with lower levels of education and income, without a regular provider, and living rural area) to maximize the use of e-communication and to support better quality of care among American adults. CLINICALTRIAL NOT APPLICABLE

Patient and Provider Factors Associated with Selected Measures of Quality of Care

PEDIATRICS ◽  
1980 ◽  
Vol 65 (2) ◽  
pp. 307-313 ◽  
Author(s):  
Howard R. Spivak ◽  
Janice C. Levy ◽  
Rosemary A. Bonanno ◽  
Minette Cracknell
Keyword(s):  
Quality Of Care ◽  
Factors Associated

scholarly journals Quality of Care for Uninsured Patients With Diabetes in a Rural Area

Diabetes Care ◽  
2002 ◽  
Vol 25 (2) ◽  
pp. 319-323 ◽  
Author(s):  
D. S. Porterfield ◽  
L. Kinsinger
Keyword(s):  
Quality Of Care ◽  
Rural Area ◽  
Uninsured Patients ◽  
Patients With Diabetes

scholarly journals Quality of care in nursing homes in Tuscany: feasibility, accuracy and portability of a monitoring system

2013 ◽  
Vol 23 (suppl_1) ◽  
Author(s):  
F Collini ◽  
M Castagnoli ◽  
E Lucenteforte ◽  
A Mugelli ◽  
N Zaffarana ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Nursing Homes ◽  
Monitoring System
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