The DOI matches its Crossref record, with a small difference in title or year; 39 of the 39 references it cites were found in a registry or an index.
Quality of Diabetes Care in U.S. Academic Medical Centers
Open accessAbstract
OBJECTIVE— To assess both standard and novel diabetes quality measures in a national sample of U.S. academic medical centers. RESEARCH DESIGN AND METHODS— This retrospective cohort study was conducted from 10 January 2000 to 10 January 2002. It involved 30 U.S. academic medical centers, which contributed data from 44 clinics (27 primary care clinics and 17 diabetes/endocrinology clinics). For 1,765 eligible adult patients with type 1 or type 2 diabetes with at least two clinic visits in the 24 months before 10 January 2002, including one visit in the 6 months before 10 January 2002, we assessed measurement and control of HbA1c, blood pressure, and cholesterol and corresponding medical regimen changes at the most recent clinic visit. RESULTS— In this ethnically and economically diverse cohort, annual testing rates were very high (97.4% for HbA1c, 96.6% for blood pressure, and 87.6% for total cholesterol). Fewer patients were at HbA1c goal (34.0% <7.0%) or blood pressure goal (33.0% <130/80 mmHg) than lipid goals (65.1% total cholesterol <200 mg/dl, 46.1% with LDL cholesterol <100 mg/dl). Only 10.0% of the cohort met recommended goals for all three risk factors. At the most recent clinic visit, 40.4% of patients with HbA1c concentrations above goal underwent adjustment of their corresponding regimens. Among untreated patients, few with elevated blood pressure (10.1% with blood pressure >130/80 mmHg) or elevated LDL cholesterol (5.6% with LDL >100 mg/dl) were started on corresponding therapy. Patients with type 2 diabetes were no less likely to be intensified than patients with type 1 diabetes. CONCLUSIONS— High rates of risk factor testing do not necessarily translate to effective metabolic control. Low rates of medication adjustment among patients with levels above goal suggest a specific and novel target for quality improvement measurement.
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“Multiple factors other than patient behavior affect diabetes treatment outcomes, including adequacy of medical management, duration of diabetes, weight gain, and other health-related (e.g., comorbid illness and concomitant medication) and social-structural factors (e.g., poverty, access to care, health insurance coverage) (13–16).”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [13]
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Metadata
- Authors
- Grant, R. W., Buse, J. B., Meigs, J. B., & for the University HealthSystem Consortium (UHC) Diabetes Benchmarking Project Team
- Affiliations
- Harvard University (US)
- University of North Carolina at Chapel Hill (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2005-02-01
- Volume
- 28
- Issue
- 2
- Pages
- 337-442
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3829636
- OpenAlex
- W2130203112
- Cited by
- 311
- References
- 39
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 2 · 2019: 8 · 2018: 7 · 2017: 5 · 2016: 12 · 2015: 13 · 2014: 18 · 2013: 23 · 2012: 22
- FWCI
- 22.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK067452)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Keywords
- diabetes care quality, academic medical centers, HbA1c control, blood pressure control, cholesterol management, metabolic control, medication intensification, type 1 diabetes, type 2 diabetes, quality improvement measures, primary health centers, endocrinology clinic
- MeSH terms
- Academic Medical Centers, Adult, Aged, Blood Pressure, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Cholesterol, LDL, Male, Middle Aged, Quality of Health Care, Retrospective Studies, Risk Factors, United States, Cohort Studies
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