Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico

BMC Medical Informatics and Decision Making

Research Article

Michael Law¹  Anita K Wagner²  Dennis Ross-Degnan²  Aakanksha H Pande²  Ricardo Pérez-Cuevas³  Francisco Espinosa-Larrañaga⁴  Magdalena Suarez-Ortega⁵  Svetlana V Doubova⁵  Jorge Escobedo⁶ 

[1] Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, Canada;Department of Population Medicine and WHO Collaborating Center in Pharmaceutical Policy, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA;Division of Social Protection and Health, Inter-American Development Bank, Washignton, USA;División de Innovación de la Coordinación de Educación en Salud,IMSS, México, DF, Mexico;Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, México, DF, Mexico;Unidad de Investigación en Epidemiología Clínica, Hospital Regional 1 Carlos MacGregor Sánchez Navarro, IMSS, México, DF, Mexico;

关键词: Metformin;    Acarbose;    Electronic Health Record;    T2DM Patient;    Care Indicator;   

DOI  :  10.1186/1472-6947-12-50

 received in 2011-11-30, accepted in 2012-06-06,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundSeveral low and middle-income countries are implementing electronic health records (EHR). In the near future, EHRs could become an efficient tool to evaluate healthcare performance if appropriate indicators are developed. The aims of this study are: a) to develop quality of care indicators (QCIs) for type 2 diabetes (T2DM) in the Mexican Institute of Social Security (IMSS) health system; b) to determine the feasibility of constructing QCIs using the IMSS EHR data; and c) to evaluate the quality of care (QC) provided to IMSS patients with T2DM.MethodsWe used a three-stage mixed methods approach: a) development of QCIs following the RAND-UCLA method; b) EHR data extraction and construction of indicators; c) QC evaluation using EHR data from 25,130 T2DM patients who received care in 2009.ResultsWe developed 18 QCIs, of which 14 were possible to construct using available EHR data. QCIs comprised both process of care and health outcomes. Several flaws in the EHR design and quality of data were identified. The indicators of process and outcomes of care suggested areas for improvement. For example, only 13.0% of patients were referred to an ophthalmologist; 3.9% received nutritional counseling; 63.2% of overweight/obese patients were prescribed metformin, and only 23% had HbA1c <7% (or plasma glucose ≤130 mg/dl).ConclusionsEHR data can be used to evaluate QC. The results identified both strengths and weaknesses in the electronic information system as well as in the process and outcomes of T2DM care at IMSS. This information can be used to guide targeted interventions to improve QC.

【 授权许可】

Unknown   
© Perez-Cuevas et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.