Impact of socio-economic position on health and quality of care in adults with Type 2 diabetes in France: the Entred 2007 study

2015 ◽  
Vol 32 (11) ◽  
pp. 1438-1444 ◽  
Author(s):  
S. Fosse-Edorh ◽  
A. Fagot-Campagna ◽  
B. Detournay ◽  
H. Bihan ◽  
E. Eschwege ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Economic Position

scholarly journals Clinical profiles and quality of care of subjects with type 2 diabetes according to their cardiovascular risk: an observational, retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Basilio Pintaudi ◽  
Alessia Scatena ◽  
Gabriella Piscitelli ◽  
Vera Frison ◽  
Salvatore Corrao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cardiovascular Risk Factors ◽  
High Cardiovascular Risk ◽  
Very High

Abstract Background The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 2 diabetes (T2D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care, with particular regard to cardiovascular risk factors. Methods The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD Annals initiative. Patients with T2D were stratified by cardiovascular risk. General descriptive indicators, measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment for diabetes and cardiovascular risk factors, presence of other complications and overall quality of care were evaluated. Results Overall, 473,740 subjects with type 2 diabetes (78.5% at very high cardiovascular risk, 20.9% at high risk and 0.6% at moderate risk) were evaluated. Among people with T2D at very high risk: 26.4% had retinopathy, 39.5% had albuminuria, 18.7% had a previous major cardiovascular event, 39.0% had organ damage, 89.1% had three or more risk factors. The use of DPP4-i markedly increased as cardiovascular risk increased. The prescription of secretagogues also increased and that of GLP1-RAs tended to increase. The use of SGLT2-i was still limited, and only slightly higher in subjects with very high cardiovascular risk. The overall quality of care, as summarized by the Q score, tended to be lower as the level of cardiovascular risk increased. Conclusions A large proportion of subjects with T2D is at high or very high risk. Glucose-lowering drug therapies seem not to be adequately used with respect to their potential advantages in terms of cardiovascular risk reduction. Several actions are necessary to improve the quality of care.

scholarly journals Impact of electronic diabetes registry ‘Meaningful Use’ on quality of care and hospital utilization

2015 ◽  
Vol 23 (2) ◽  
pp. 242-247 ◽  
Author(s):  
Wencui Han ◽  
Raj Sharman ◽  
Arvela Heider ◽  
Nancy Maloney ◽  
Min Yang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Hierarchical Linear Modeling ◽  
Meaningful Use ◽  
Hospital Utilization ◽  
Utilization Rate ◽  
Diabetic Patients ◽  
Diabetes Registry

Abstract Objective To investigate whether the use of diabetes registries meeting Meaningful Use core objectives in primary care practices is associated with differences in quality of care and hospital utilization rates. Materials and methods A practice assessment survey was conducted to identify whether and how practices were using diabetes registries. Insurance claims data from 2010 were used to compare the health outcomes of patients from practices that used diabetes registries meeting Meaningful Use–related objectives to the outcomes of patients from other practices. Logistic hierarchical linear modeling was used to analyze the data. Results Records from 12,514 diabetic patients (including 10 809 with type 2 diabetes) from 50 urban practices were included in the analysis. The results suggest that patients with type 2 diabetes who were treated in practices using registries for patient reminders were more likely to have completed the recommended laboratory testing (odds ratio [OR] 1.26, p < 0.01) and dilated retinal examinations (OR 1.14, p < 0.01). Patients in practices using registries for quality improvement were less likely to have ‘avoidable hospitalization’ (OR 0.83, p < 0.01) and emergency room visits (OR 0.76, p < 0.01). The use of a diabetes registry did not have a significant impact on the quality of care or hospital utilization for patients with type 1 diabetes. Conclusion Use of diabetes registries meeting Meaningful Use core objectives is associated with higher completion or recommended lab tests and a lower hospital utilization rate for patients with type 2 diabetes.

Prevalence and quality of care indicators of type 2 diabetes in the population of the Basque Country (Spain)

2015 ◽  
Vol 31 (2) ◽  
pp. 72-79 ◽  
Author(s):  
Edurne Alonso-Morán ◽  
Juan F. Orueta ◽  
Jose Ignacio Fraile Esteban ◽  
Jose Mª Arteagoitia Axpe ◽  
Mari Luz Marqués González ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Quality Of Care ◽  
Basque Country

scholarly journals Prevalence of amputations amongst people with type 2 diabetes enrolled in primary care in England

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Meza-Torres ◽  
C Heiss ◽  
S Cunningham ◽  
F Carinci ◽  
S de Lusignan
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Quality Of Care ◽  
General Practitioners ◽  
Distinct Pattern ◽  
National Database ◽  
Cross Sectional ◽  
Clinical Records

Abstract Background Different patterns of co-morbidities observed among people with type 2 diabetes (T2D) and lower extremity amputations (LEA) compared with those without may provide insights into the quality of care provided by general practitioners in England. We analysed routinely recorded clinical data to build predictive models for benchmarking and continuous improvement. Methods A cross-sectional computerized data extraction of clinical records from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) database of people with T2D in England. Key target cases were defined as adults with T2D and a record of major/minor LEA between 2008-2019 vs all subjects with T2D without amputation. Quality of care was assessed in terms of percentage of patients treated with optimal medical therapy and diagnostic procedures and referred to specialized care according to their clinical profile. The association between quality of care and outcomes was explored using a logistic regression model, adjusting for case-mix. Results During the last decade, in a sample covering approximately 7.4% of all general practitioners in England, a total of 1,052 subjects out of 127,100 adults with T2D had a LEA (832 per 100,000). The median time since amputation was 3.4 years. Only 410 (38%) patients had a recorded DFU diagnosis prior to the amputation, with a median of 2 years from diagnosis to amputation. Major LEA was recorded in 280 (27%) cases. People with a record of retinopathy, peripheral arterial disease, renal disease, neuropathy and DFU had a higher risk of amputations. Quality of care was heterogeneous between patients with and without LEA. Conclusions People with T2D and LEA have a distinct pattern of co-morbidities some of which may be sensitive to improved primary care management, and differential quality of care. Models built using this national database can routinely monitor amputations in England. Variation in treatment should be properly investigated. Key messages The automated extraction of clinical cases from a national database may help shed light on clinical patterns among people with diabetes at high risk of amputations, based on evidence-based criteria. Variation in treatment and quality of care among amputated vs non-amputated subjects can be rapidly explored using a cross-sectional analysis of current records.

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