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Strategies and Factors Associated With Top Performance in Primary Care for Diabetes: Insights From a Mixed Methods Study
- Source :
- Annals of Family Medicine. March-April, 2021, Vol. 19 Issue 2, p110, 7 p.
- Publication Year :
- 2021
-
Abstract
- PURPOSE The aim of this study was to determine what strategies and factors are most important for high performance in the primary care of patients with diabetes. METHODS We performed a mixed-methods, cross-sectional, observational analysis of interviews and characteristics of primary care clinics in Minnesota and bordering areas. We compared strategies, facilitators, and barriers identified by 31 leaders of 17 clinics in high-, middle-, and low-performance quartiles on a standardized composite measure of diabetes outcomes for 416 of 586 primary care clinics. Semistructured interview data were combined with quantitative data regarding clinic performance and a survey of the presence of care management processes. RESULTS The interview analysis identified 10 themes providing unique insights into the factors and strategies characterizing the 3 performance groups. The main difference was the degree to which top-performing clinics used patient data to guide proactive and outreach methods to intensify treatment and monitor effect. Top clinics also appeared to view visit-based care management processes as necessary but insufficient, whereas all respondents regarded being part of a large system as mostly helpful. CONCLUSIONS Top-performing clinic approaches to diabetes care differ from lower-performing clinics primarily by emphasizing data-driven proactive outreach to patients to intensify treatment. Although confirmatory studies are needed, clinical leaders should consider the value of this paradigm shift in approach to care. Key words: quality of health care; diabetes mellitus; delivery of health care; primary health care; organizational culture<br />INTRODUCTION In a recent study of US National Health and Nutrition Examination Survey data, Kazemian et al reported that measures of diabetes care outcomes did not improve from 2005 to [...]
Details
- Language :
- English
- ISSN :
- 15441709
- Volume :
- 19
- Issue :
- 2
- Database :
- Gale General OneFile
- Journal :
- Annals of Family Medicine
- Publication Type :
- Academic Journal
- Accession number :
- edsgcl.655941926
- Full Text :
- https://doi.org/10.1370/afm.2646