Ambulatory Healthcare Use Profiles of Patients With Diabetes and Their Association With Quality of Care: A Cross-Sectional Study.

Details

Ressource 1Download: fendo-13-841774.pdf (2009.91 [Ko])
State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_62E64B66FDB5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ambulatory Healthcare Use Profiles of Patients With Diabetes and Their Association With Quality of Care: A Cross-Sectional Study.
Journal
Frontiers in endocrinology
Author(s)
Dupraz J., Zuercher E., Taffé P., Peytremann-Bridevaux I.
ISSN
1664-2392 (Print)
ISSN-L
1664-2392
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
13
Pages
841774
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Despite the growing burden of diabetes worldwide, evidence regarding the optimal models of care to improve the quality of diabetes care remains equivocal. This study aimed to identify profiles of patients with distinct ambulatory care use patterns and to examine the association of these profiles with the quality of diabetes care.
We performed a cross-sectional study of the baseline data of 550 non-institutionalized adults included in a prospective, community-based, cohort study on diabetes care conducted in Switzerland. Clusters of participants with distinct patterns of ambulatory healthcare use were identified using discrete mixture models. To measure the quality of diabetes care, we used both processes of care indicators (eye and foot examination, microalbuminuria screening, blood cholesterol and glycated hemoglobin measurement [HbA1c], influenza immunization, blood pressure measurement, physical activity and diet advice) and outcome indicators (12-Item Short-Form Health Survey [SF-12], Audit of Diabetes-Dependent Quality of Life [ADDQoL], Patient Assessment of Chronic Illness Care [PACIC], Diabetes Self-Efficacy Scale, HbA1c value, and blood pressure <140/90 mmHg). For each profile of ambulatory healthcare use, we calculated adjusted probabilities of receiving processes of care and estimated adjusted outcomes of care using logistic and linear regression models, respectively.
Four profiles of ambulatory healthcare use were identified: participants with more visits to the general practitioner [GP] than to the diabetologist and receiving concomitant podiatry care ("GP & podiatrist", n=86); participants visiting almost exclusively their GP ("GP only", n=195); participants with a substantially higher use of all ambulatory services ("High users", n=96); and participants reporting more visits to the diabetologist and less visits to the GP than other profiles ("Diabetologist first", n=173). Whereas participants belonging to the "GP only" profile were less likely to report most processes related to the quality of diabetes care, outcomes of care were relatively comparable across all ambulatory healthcare use profiles.
Slight differences in quality of diabetes care appear across the four ambulatory healthcare use profiles identified in this study. Overall, however, results suggest that room for improvement exists in all profiles, and further investigation is necessary to determine whether individual characteristics (like diabetes-related factors) and/or healthcare factors contribute to the differences observed between profiles.
Keywords
Adult, Cohort Studies, Cross-Sectional Studies, Delivery of Health Care, Diabetes Mellitus/epidemiology, Diabetes Mellitus/therapy, General Practitioners, Glycated Hemoglobin A, Humans, Prospective Studies, Quality of Life, ambulatory care, cluster analysis, diabetes mellitus, outcome assessment, process assessment, profiles, quality of health care
Pubmed
Web of science
Open Access
Yes
Create date
14/04/2022 21:43
Last modification date
21/11/2022 8:19
Usage data