Identifying Substantial Racial and Ethnic Disparities in Health Outcomes and Care in Wisconsin Using Electronic Health Record Data
Identifying Substantial Racial and Ethnic Disparities in Health Outcomes and Care in Wisconsin Using Electronic Health Record Data
Although Wisconsin ranks highly in overall health care quality, the state performs poorly with respect to health disparities. To eliminate health disparities in Wisconsin, it is critical to understand where disparities exist.
Measuring disparities in health outcomes and care allows for benchmarking of current performance and monitoring changes over time. Measurement also allows stakeholders to prioritize efforts and develop and implement programs for the populations that are most impacted by disparities. Authors including HIP Investigator, Dr. Maureen Smith identified racial and ethnic disparities in health outcome and care measures in Wisconsin.
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions
Stratifying patients with diabetes into clinically relevant groups by combination of chronic conditions
Dr. Elizabeth Magnan et al. looked at combinations of chronic conditions among patients with diabetes to examine their relationships with diabetes quality metrics. They analyzed 12 conditions concordant with diabetes care to define classes based on co-occurrence: severe cardiac, cardiac, noncardiac vascular, risk factors, and no concordant comorbidities. Patients had distinct quality metric achievement by condition class, and patients in less sever chronic condition classes were less likely to achieve diabetes metrics.
The impact of a patient's concordant and discordant chronic conditions on diabetes care quality measures
The impact of a patient's concordant and discordant chronic conditions on diabetes care quality measures
Dr. Elizabeth Magnan et al. sought to determine the impact of the number of concordant and discordant chronic conditions on diabetes care quality. Using EHR data, authors found that a higher number of concordant conditions were associated with higher odds of achieving testing and control goals for all outcomes except blood pressure control. Having more concordant conditions makes diabetes care goal achievement more likely.
Establishing chronic condition concordance and discordance with diabetes
Establishing chronic condition concordance and discordance with diabetes
This study by Dr. Elizabeth Magnan et al. aimed to determine which chronic conditions are concordant and discordant with diabetes care. Using the Delphi technique, the study team surveyed PCPs in an academic practice. They found 12 conditions were concordant with diabetes care and 50 were discordant, and 31 of the discordant conditions did not overlap with any of the diabetes care goals. This study adds information that may prove useful in developing multimorbidity guidelines and interventions.
Publicly reported quality-of-care measures influenced Wisconsin physician groups to improve performance
Publicly reported quality-of-care measures influenced Wisconsin physician groups to improve performance
Investigators analyzed 14 publicly reported quality of care ambulatory measures for the Wisconsin Collaborative for Healthcare Quality to learn whether the reports impact quality of care for patients. Physician groups in the collaborative improved their performance during the study period and when surveyed, reported that the public measures motivated them to act on some, but not all, of the quality measures.
Public reporting helped drive quality improvement in outpatient diabetes care among Wisconsin physician groups
Public reporting helped drive quality improvement in outpatient diabetes care among Wisconsin physician groups
This Health Affairs article by Dr. Maureen Smith et al. examined how physician groups respond to public reporting. The authors found that publicly reported metrics, along with participation in large or externally sponsored projects, increased a clinic's implementation of diabetes improvement interventions. Accountability metrics should be structured to capture incremental improvements in quality to reward early and ongoing improvement activities.
Analysis of guidelines for screening diabetes mellitus in an ambulatory population
Analysis of guidelines for screening diabetes mellitus in an ambulatory population
This study compared the case-finding ability of current national guidelines for screening diabetes mellitus and characterized factors that affect testing practices in an ambulatory population. In this retrospective analysis, investigators found that compared with the American Diabetes Association (ADA) recommendations, the United States Preventive Services Task Force (USPSTF) guidelines result in a lower number of patients eligible for screening and decreased case-finding significantly. The number and type of risk factors predict diabetes, and lack of health insurance decreases testing.