Quality of care of Medicare patients with diabetes in a metropolitan fee-for-service primary care integrated delivery system

Am J Med Qual. 2005 Nov-Dec;20(6):344-52. doi: 10.1177/1062860605280205.

Abstract

Diabetes care in the United States is suboptimal. Although closed-panel health maintenance organizations (HMOs) and the Department of Veterans Affairs (VA) report performance superior to national norms, fee-for-service performance is uncertain. To address this issue, 3 outcome and 5 process indicators were measured for 2010 Medicare diabetes patients across 22 sites in a large, fee-for-service primary care group practice. American Diabetes Association standards for glycemic control, low-density lipoprotein cholesterol, and blood pressure were met by 53%, 46%, and 19% of patients, respectively. Diabetes Quality Improvement Project/Alliance poor control markers for the same measures were exceeded by 9%, 20%, and 54% of patients. Chart abstraction demonstrated annual eye examination, foot examination, and nephropathy screening rates of 16%, 49%, and 38%, while Medicare claims showed an annual eye examination rate of 63%. Observed processes and outcomes in this fee-for-service setting were superior to reported national performance and similar to the best performance in staff-model HMOs and the VA.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Delivery of Health Care, Integrated / standards*
  • Diabetes Mellitus / therapy*
  • Fee-for-Service Plans / standards*
  • Female
  • Humans
  • Male
  • Medicare / standards*
  • Outcome and Process Assessment, Health Care*
  • Primary Health Care / organization & administration
  • Primary Health Care / standards*
  • Quality Indicators, Health Care
  • Retrospective Studies
  • Texas