Effects of patient volume on quality of outpatient diabetes care.
Diabetes Res Clin Pract
; 84(2): e27-9, 2009 May.
Article
en En
| MEDLINE
| ID: mdl-19269708
ABSTRACT
In this study we aimed to evaluate the effects of practice size (patient volume) and diabetes caseload in outpatient services on the quality of diabetes care in a teaching hospital. We analyzed the medical records of 2038 diabetic patients treated at a medical center in central Taiwan between January and June 2007. Outpatient practice size (including diabetic and non-diabetic patients) per clinic decreased the odds of glycated hemoglobin (A1C) testing (13% less for every 10 increase in outpatient encounters; p<0.001), and the percentage of A1C values<7% (8% less for every 10 increase in outpatient encounters; p=0.03) in diabetic patients treated by non-endocrinologists. However, a higher caseload of patients with diabetes was associated with an increased lipid profile measurement (19% more for every 5 increase in diabetic patients; p<0.001). In diabetic patients treated by endocrinologists, a higher patient volume was associated with increased odds of low-density-lipoprotein cholesterol (LDL-C) levels<100mg/dl, although there was no effect on the measurement and values of A1C. In conclusion, our study demonstrated some evidence of patient volume-outcome relationship in the management of diabetes in different specialties. This finding can have some implications to the health care system and the referral policy.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Pacientes Ambulatorios
/
Garantía de la Calidad de Atención de Salud
/
Diabetes Mellitus
/
Atención Ambulatoria
Límite:
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
Diabetes Res Clin Pract
Asunto de la revista:
ENDOCRINOLOGIA
Año:
2009
Tipo del documento:
Article
País de afiliación:
Taiwán