Implementation of Screening Guidelines to Improve Quality of Care in a Small, Ethnically Diverse Pediatric Primary Care Practice…Then What?

ObjectivesThe aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population.DesignA cross-sectional survey study.SettingPrimary care practice population.ParticipantsA sample (n=5562) of patients in two general practitioner practices in the Netherlands.Primary outcome measuresThe Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression.ResultsOverall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95).ConclusionThis study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.

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Improving the Quality of Diabetes Care in Primary Care Practice

Journal for Healthcare Quality ◽

10.1111/j.1945-1474.2004.tb00502.x ◽

2004 ◽

Vol 26 (4) ◽

pp. 14-21 ◽

Cited By ~ 14

Author(s):

Janice C. Zgibor ◽

Harsha Rao ◽

Jacqueline Wesche-Thobaben ◽

Nancie Gallagher ◽

Janis McWilliams ◽

...

Keyword(s):

Primary Care ◽

Diabetes Care ◽

Primary Care Practice ◽

Care Practice ◽

Quality Of Diabetes Care

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Will changes in primary care improve health outcomes? Modelling the impact of financial incentives introduced to improve quality of care in the UK

BMJ Quality & Safety ◽

10.1136/qshc.2003.007401 ◽

2004 ◽

Vol 13 (3) ◽

pp. 191-197 ◽

Cited By ~ 26

Author(s):

P McElduff

Keyword(s):

Primary Care ◽

Quality Of Care ◽

Health Outcomes ◽

Financial Incentives ◽

Improve Quality ◽

The Uk ◽

The Impact ◽

Improve Health

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Identification of Overweight Status Is Associated With Higher Rates of Screening for Comorbidities of Overweight in Pediatric Primary Care Practice

PEDIATRICS ◽

10.1542/peds.2005-2867 ◽

2007 ◽

Vol 119 (1) ◽

pp. e148-e155 ◽

Cited By ~ 55

Author(s):

K. J. Dilley ◽

L. A. Martin ◽

C. Sullivan ◽

R. Seshadri ◽

H. J. Binns ◽

...

Keyword(s):

Primary Care ◽

Primary Care Practice ◽

Pediatric Primary Care ◽

Care Practice ◽

Overweight Status

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Multistrategic approach to improve quality of care of people with diabetes at the primary care level: Study design and baseline data

Primary Care Diabetes ◽

10.1016/j.pcd.2016.12.002 ◽

2017 ◽

Vol 11 (2) ◽

pp. 193-200 ◽

Cited By ~ 5

Author(s):

Mariana Prestes ◽

María Angelica Gayarre ◽

Jorge Federico Elgart ◽

Lorena Gonzalez ◽

Enzo Rucci ◽

...

Keyword(s):

Primary Care ◽

Quality Of Care ◽

Study Design ◽

Baseline Data ◽

Improve Quality ◽

Care Level ◽

Primary Care Level

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Development and Operationalization of a Data Framework to Assess Quality of Integrated Diabetes Care in the Fragmented Data Landscape of Belgium

10.21203/rs.3.rs-1173627/v1 ◽

2022 ◽

Author(s):

Veerle Buffel ◽

Katrien Danhieux ◽

Philippe Bos ◽

Roy Remmen ◽

Josefien Van Olmen ◽

...

Keyword(s):

Primary Care ◽

Quality Of Care ◽

Quality Indicators ◽

Diabetes Care ◽

Care Practice ◽

Data Framework ◽

Related Quality ◽

Quality Of Diabetes Care ◽

Sampling Procedures

Abstract Background. To assess the quality of integrated diabetes care, we should be able to follow the patient throughout the care path, monitor his/her care process and link them to his/her health outcomes, while simultaneously link this information to the primary care system and its performance on the structure and organization related quality indicators. However the development process of such a data framework is challenging, even in period of increasing and improving health data storage and management. This study aims to develop an integrated multi-level data framework for quality of diabetes care and to operationalize this framework in the fragmented Belgium health care and data landscape.Methods. Based on document reviews and iterative expert consultations, theoretical approaches and quality indicators were identified and assessed. After mapping and assessing the validity of existing health information systems and available data sources through expert consultations, the theoretical framework was translated in a data framework with measurable quality indicators. The construction of the data base included sampling procedures, data-collection, and several technical and privacy-related aspects of linking and accessing Belgian datasets.Results. To address three dimensions of quality of care, we integrated the chronic care model and cascade of care approach, addressing respectively the structure related quality indicators and the process and outcome related indicators. The corresponding data framework is based on self-collected data at the primary care practice level (using the Assessment of quality of integrated care tool), and linked health insurance data with lab data at the patient level. Conclusion. In this study, we have described the transition of a theoretical quality of care framework to a unique multilevel database, which allows assessing the quality of diabetes care, by considering the complete care continuum (process and outcomes) as well as organizational characteristics of primary care practices.

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