Document Detail


Quality of care for hypertensive patients with type 2 diabetes in a rural area of Southern Italy: is the recording of patient data and the achievement of quality indicators targets satisfactory?
MedLine Citation:
PMID:  20843159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Type 2 diabetes mellitus and hypertension are commonly associated chronic conditions which require regular structured treatment. In the UK many quality markers have been improved through an incentivisation scheme. The aim of this study was to discover if there is potential for improving the quality of care for patients with type 2 diabetes and hypertension in rural Italy, through a quality and outcome incentivisation scheme.
METHODS: The study was conducted in a rural practice context in Southern Italy and seven family doctors were involved. The main outcome measures were glycated haemoglobin A1c (HbA1c), LDL cholesterol, and systolic and diastolic blood pressure. The patient characteristics examined were age, sex, educational level, behaviour-related factors such as smoking and BMI, and the presence of comorbidities.
RESULTS: A poor level of registration was found for important variables such as HBA1c (61.4% compared with the UK Quality Indicator of 90%). An adequate level of registration and control was found only for blood pressure (95.7% and 82.1%, respectively), while an acceptable but not optimal level of control for HBA1c was also achieved (88.4% ≤10%). In comparison with levels in UK practices, the Italian district studied performed much less favorably, especially regarding process indicators. Intermediate outcome and treatment indicators were slightly better for blood pressure control but slightly worse for HBA1c and cholesterol control.
CONCLUSION: The data confirm a poor registration level for important healthcare indicators in the study area, and that optimal levels are rarely reached for many quality indicators. A quality and outcome incentivisation scheme similar to the UK Quality and Outcomes Framework may offer a tool for achieving improvements.
Authors:
Ferdinando Petrazzuoli; Jean K Soler; Nicola Buono; Frank Dobbs
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-13
Journal Detail:
Title:  Rural and remote health     Volume:  10     ISSN:  1445-6354     ISO Abbreviation:  Rural Remote Health     Publication Date:    2010 Jul-Sep
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101174860     Medline TA:  Rural Remote Health     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1258     Citation Subset:  IM    
Affiliation:
SNAMID Caserta, Caserta, Campania, Italy. 0823860032@iol.it
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Diabetes Mellitus, Type 2 / complications*,  therapy*
Educational Status
Health Behavior
Humans
Hypertension / complications*,  therapy*
Italy
Middle Aged
Quality Indicators, Health Care
Quality of Health Care / statistics & numerical data*
Rural Health Services / organization & administration,  statistics & numerical data*
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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