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dc.contributor.authorSalanitro, Amanda H.
dc.contributor.authorSafford, Monika M.
dc.contributor.authorHouston, Thomas K.
dc.contributor.authorWilliams, Jessica H.
dc.contributor.authorOvalle, Fernando
dc.contributor.authorPayne-Foster, Pamela
dc.contributor.authorAllison, Jeroan J.
dc.contributor.authorEstrada, Carlos A.
dc.date2022-08-11T08:10:33.000
dc.date.accessioned2022-08-23T17:12:34Z
dc.date.available2022-08-23T17:12:34Z
dc.date.issued2011-03-15
dc.date.submitted2012-04-16
dc.identifier.citationJ Natl Med Assoc. 2011 Mar;103(3):234-40.
dc.identifier.issn0027-9684 (Linking)
dc.identifier.pmid21671526
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46533
dc.description.abstractPURPOSE: Even though pay-for-performance programs are being rapidly implemented, little is known about how patient complexity affects practice-level performance assessment in rural settings. We sought to determine the association between patient complexity and practice-level performance in the rural United States. BASIC PROCEDURES: Using baseline data from a trial aimed at improving diabetes care, we determined factors associated with a practice's proportion of patients having controlled diabetes (hemoglobin A1c MAIN FINDINGS: Rural primary care practices (n=135) in 11 southeastern states provided information for 1641 patients with diabetes. For practices in the best quartile of observed control, 76.1% of patients had controlled diabetes vs 19.3% of patients in the worst quartile. After controlling for other variables, proportions of diabetes control were 10% lower in those practices whose patients had the greatest difficulty with either self testing or appointment keeping (p PRINCIPAL CONCLUSIONS: Basing public reporting and resource allocation on quality assessment that does not account for patient characteristics may further harm this vulnerable group of patients and physicians.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=21671526&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156053/pdf/nihms313984.pdf
dc.subjectAge Factors
dc.subjectAged
dc.subjectAlabama
dc.subjectData Interpretation, Statistical
dc.subjectDiabetes Mellitus
dc.subjectFemale
dc.subjectHemoglobin A, Glycosylated
dc.subjectHumans
dc.subjectHypoglycemic Agents
dc.subjectInsulin
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPhysician's Practice Patterns
dc.subjectPrimary Health Care
dc.subject*Quality of Health Care
dc.subjectRandomized Controlled Trials as Topic
dc.subjectRisk Factors
dc.subjectRural Health Services
dc.subjectRural Population
dc.subjectUnited States
dc.subjectUMCCTS funding
dc.subjectBiostatistics
dc.subjectEndocrine System Diseases
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.subjectNutritional and Metabolic Diseases
dc.titlePatient complexity and diabetes quality of care in rural settings
dc.typeJournal Article
dc.source.journaltitleJournal of the National Medical Association
dc.source.volume103
dc.source.issue3
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1000
dc.identifier.contextkey2767202
html.description.abstract<p>PURPOSE: Even though pay-for-performance programs are being rapidly implemented, little is known about how patient complexity affects practice-level performance assessment in rural settings. We sought to determine the association between patient complexity and practice-level performance in the rural United States.</p> <p>BASIC PROCEDURES: Using baseline data from a trial aimed at improving diabetes care, we determined factors associated with a practice's proportion of patients having controlled diabetes (hemoglobin A1c</p> <p>MAIN FINDINGS: Rural primary care practices (n=135) in 11 southeastern states provided information for 1641 patients with diabetes. For practices in the best quartile of observed control, 76.1% of patients had controlled diabetes vs 19.3% of patients in the worst quartile. After controlling for other variables, proportions of diabetes control were 10% lower in those practices whose patients had the greatest difficulty with either self testing or appointment keeping (p</p> <p>PRINCIPAL CONCLUSIONS: Basing public reporting and resource allocation on quality assessment that does not account for patient characteristics may further harm this vulnerable group of patients and physicians.</p>
dc.identifier.submissionpathqhs_pp/1000
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages234-40


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