Dataset Information

Organizational determinants of high-quality routine diabetes care.

ABSTRACT:

Objective

Randomized trials showed that changes in healthcare organization improved diabetes care. This study aimed to identify which organizational determinants were associated with patient outcomes in routine diabetes care.

Design

Observational study, in which multilevel regression analyses were applied to examine the impact of 12 organizational determinants on diabetes care as separate measures and as a composite score.

Setting

Primary care practices in the Netherlands.

Subjects

11,751 patients with diabetes in 354 practices.

Main outcome measures

Patients' recorded glycated hemoglobin (HbA1c), systolic blood pressure, and serum cholesterol levels.

Results

A higher score on the composite measure of organizational determinants was associated with better control of systolic blood pressure (p = 0.017). No effects on HbA1C or cholesterol levels were found. Exploration of specific organizational factors found significant impact of use of an electronic patient registry on HbA1c (OR = 1.80, 95% CI 1.12-2.88), availability of patient leaflets on systolic blood pressure control (OR = 2.59, 95% CI 1.06-6.35), and number of hours' nurse education on cholesterol control (OR = 2.51, 95% CI 1.02-6.15).

Conclusion

In routine primary care, it was found that favorable healthcare organization was associated with a number of intermediate outcomes in diabetes care. This finding lends support to the findings of trials on organizational changes in diabetes care. Notably, the composite measure of organizational determinants had most impact.

SUBMITTER: van Doorn-Klomberg AL

PROVIDER: S-EPMC4206557 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Publications

Organizational determinants of high-quality routine diabetes care.

van Doorn-Klomberg Arna L AL Braspenning Jozé C C JC Wolters René J RJ Bouma Margriet M de Grauw Wim J C WJ Wensing Michel M

Scandinavian journal of primary health care 20140929 3

<h4>Objective</h4>Randomized trials showed that changes in healthcare organization improved diabetes care. This study aimed to identify which organizational determinants were associated with patient outcomes in routine diabetes care.<h4>Design</h4>Observational study, in which multilevel regression analyses were applied to examine the impact of 12 organizational determinants on diabetes care as separate measures and as a composite score.<h4>Setting</h4>Primary care practices in the Netherlands.< ...[more]

PMID: 25264939

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Dataset Information

Organizational determinants of high-quality routine diabetes care.

Objective

Design

Setting

Subjects

Main outcome measures

Results

Conclusion

Publications

Organizational determinants of high-quality routine diabetes care.

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