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    Quality measure attainment in patients with type 2 diabetes mellitus

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    Authors
    Lafeuille, Marie-Helene
    Grittner, Amanda M.
    Gravel, Jonathan
    Bailey, Robert A.
    Martin, Silas
    Garber, Lawrence D.
    Sheng Duh, Mei
    Lefebvre, Patrick
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2014-01-01
    Keywords
    Endocrine System Diseases
    Endocrinology, Diabetes, and Metabolism
    Health Services Administration
    
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    Link to Full Text
    http://www.ajmc.com/publications/supplement/2014/a481_jan14_t2dm/A481_jan14_T2DM_Lafeuille_S5
    Abstract
    OBJECTIVES: This study examined the demographics, comorbidities, clinical characteristics, and treatments of people with type 2 diabetes mellitus (T2DM) treated with metformin and sulfonylurea as well as an elderly subgroup. Achievement of predefined quality measure goals (glycated hemoglobin [A1C], blood pressure [BP], low-density lipoprotein cholesterol [LDL-C], body mass index [BMI]) and their association with diabetes-related healthcare costs were assessed. STUDY DESIGN: The study applied a retrospective longitudinal cohort design. METHODS: Health insurance claims and electronic medical records from 14,532 adults with T2DM (2007- 2011) were used to identify a sample receiving metformin and sulfonylurea (MET+SU) concomitantly. The index date was the first dispensing of MET+SU after 6 months of eligibility. Clinical characteristics were assessed during baseline. Quality measure attainment (A1C < 8%, BP < 140/90 mm Hg, LDL-C level < 100 mg/dL, BMI < 30 kg/m(2)), was evaluated during the 12 months following the index date. Association between attainment and diabetes-related costs was evaluated using non-parametric bootstrap methods adjusting for imbalance in baseline characteristics between cohorts. RESULTS: Among 2044 patients, including 1283 patients 65 years and older, hyperlipidemia, hypertension, and cardiovascular disease were the most common baseline comorbidities. Quality measure goal attainment was 63.9% for A1C, 33.1% for BP, 68.2% for LDL-C level, and 34.4% for BMI, and was associated with significantly lower diabetes-related costs per patient per year compared with nonattainment (adjusted mean cost differences: -$1445 for A1C; -$1218 for BMI; -$2029 for A1C and BMI; -$2073 for A1C, BMI, and BP; all P < .05). CONCLUSION: This study highlights the high incidence of comorbidities and potential financial implications of attaining T2DM quality outcomes.
    Source
    Am J Manag Care. 2014 Jan;20(1 Suppl):s5-15.
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37291
    PubMed ID
    24512194
    Related Resources
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