Diabetes quality management in Dutch care groups and outpatient clinics: a cross-sectional study

BMC Research Notes

Guy EHM Rutten¹  Lidwien C Lemmens²  Caroline A Baan²  Marjo JE Campmans-Kuijpers¹ 

[1] Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Heidelberglaan 100, 3508 GA Utrecht, the Netherlands;Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, A. van Leeuwenhoeklaan 9, 3721 MA Bilthoven, the Netherlands

关键词: Diabetes care group;    Quality improvement;    Quality management;    Diabetes care;   

Others  :  1131716
DOI  :  10.1186/1756-0500-7-497

 received in 2013-10-01, accepted in 2014-07-30,  发布年份 2014

【 摘 要 】

Background

In recent years, most Dutch general practitioners started working under the umbrella of diabetes care groups, responsible for the organisation and coordination of diabetes care. The quality management of these new organisations receives growing interest, although its association with quality of diabetes care is yet unclear. The best way to measure quality management is unknown and it has not yet been studied at the level of outpatient clinics or care groups. We aimed to assess quality management of type 2 diabetes care in care groups and outpatient clinics.

Results

Quality management was measured with online questionnaires, containing six domains (see below). They were divided into 28 subdomains, with 59 (care groups) and 57 (outpatient clinics) questions respectively. The mean score of the domains reflects the overall score (0-100%) of an organisation. Two quality managers of all Dutch care groups and outpatient clinics were invited to fill out the questionnaire.

Sixty care groups (response rate 61.9%) showed a mean score of 59.6% (CI 57.1-62.1%). The average score in 52 outpatient clinics (response rate 50.0%) was 61.9% (CI 57.5-66.8%).

Mean scores on the six domains for care groups and outpatient clinics respectively were: ‘organisation of care’ 71.9% (CI 68.8-74.9%), 76.8% (CI 72.8-80.7%); ‘multidisciplinary teamwork’ 67.1% (CI 62.4-71.9%), 71.5% (CI 65.3-77.8%); ‘patient centeredness’ 46.7% (CI 42.6-50.7%), 62.5% (CI 57.7-67.2%); ‘performance management’ 63.3% (CI 61.2-65.3%), 50.9% (CI 44.2-57.5%); ‘quality improvement policy’ 52.6% (CI 49.2-56.1%), 50.9% (CI 44.6-57.3%); and ‘management strategies’ 56.0% (CI 51.4-60.7%), 59.0% (CI 52.8-65.2%). On subdomains, care groups scored highest on ‘care program’ (83.3%) and ‘measured outcomes’ (98.3%) and lowest on ‘patient safety’ (15.1%) and ‘patient involvement’ (17.7%). Outpatient clinics scored high on the presence of a ‘diabetic foot team’ (81.6%) and the support in ‘self-management’ (81.0%) and low on ‘patient involvement’ (26.8%) and ‘inspection of medical file’ (28.0%).

Conclusions

This nationwide assessment reveals that the level of quality management in diabetes care varies between several subdomains in both diabetes care groups and outpatient clinics.

【 授权许可】

   
2014 Campmans-Kuijpers et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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