Table 4.
Comparison of the Process Outcomes, 1992 through 1996 for Both Health Care Settings, and 1992 through 1995 for the EMC, versus 1994 through 1997 for GHC
| 1992 | 19931 | 1994 | 19952 | 1996 | 1997 | RR/OR [95% CI] NL 1992–1996 versus U.S. 1992–19968 | RR/OR [95% CI] NL 1992–1995 versus U.S. 1994–19978 | ||
|---|---|---|---|---|---|---|---|---|---|
| Number of patients in the study | EMC | 379 | 379 | 368 | 342 | 303 | NA | ||
| GHC | 2,119 | 2,119 | 1,976 | 1,867 | 1,561 | 1,361 | |||
| Mean number of diabetes-visits3 | EMC | 3.51 | 4.50 | 4.64 | 4.83 | 5.57 | NA | RR: 2.49 | RR: 3.01 |
| GHC | 2.37 | 1.74 | 1.61 | 1.63 | 1.62 | 1.47 | [2.20–2.82] | [2.56–3.43] | |
| Mean number of HbA1c measurements3 | EMC | 0.29 | 1.01 | 1.10 | 1.01 | 1.10 | NA | RR: 0.44 | RR: 0.49 |
| GHC | 2.04 | 1.70 | 1.67 | 1.76 | 1.89 | 1.88 | [0.37–0.52] | [0.42–0.57] | |
| Mean number glucose measurements3 | EMC | 3.52 | 4.50 | 4.64 | 4.82 | 5.54 | NA | RR: 1.65 | RR: 1.96 |
| GHC | 3.38 | 2.79 | 2.56 | 2.57 | 2.55 | 2.28 | [1.54–1.77] | [1.70–2.26] | |
| ≥1 HbA1c measurement4 | EMC | 15.3 | 79.2 | 70.7 | 62.0 | 57.4 | NA | OR: 0.24 | OR: 0.20 |
| GHC | 77.3 | 77.2 | 77.1 | 77.6 | 80.7 | 84.1 | [0.17–0.35] | [0.15–0.29] | |
| Glycemic control 4,5 | EMC | 12.1 | 70.2 | 64.9 | 58.2 | 56.1 | NA | OR: 0.62 | OR: 0.79 |
| GHC | 54.9 | 51.8 | 50.9 | 52.0 | 54.7 | 52.7 | [0.44–0.86] | [0.55–1.13] | |
| ≥1 cholesterol measurement 4 | EMC | 17.9 | 80.5 | 68.8 | 58.5 | 52.8 | NA | OR: 1.86 | OR: 1.66 |
| GHC | 38.1 | 39.1 | 40.9 | 40.8 | 45.8 | 52.6 | [1.32–2.64] | [1.16–2.37] | |
| ≥1 serum creatinine measurement4 | EMC | 20.3 | 79.2 | 68.2 | 59.6 | 56.1 | NA | OR: 0.38 | OR: 0.38 |
| GHC | 67.6 | 69.3 | 69.2 | 69.6 | 73.4 | 74.4 | [0.28–0.52] | [0.27–0.54] | |
| Adequate quality of care (GHC guidelines)4,6 | EMC | 6.9 | 72.3 | 63.3 | 52.9 | 47.9 | NA | OR: 1.80 | OR: 1.50 |
| GHC | 30.3 | 32.8 | 34.2 | 34.3 | 41.7 | 46.6 | [1.26–2.56] | [1.05–2.13] | |
| Adequate quality of care (EMC guidelines)4,7 | EMC | 5.5 | 64.6 | 57.9 | 50.0 | 46.9 | NA | OR: 2.07 | OR: 1.83 |
| GHC | 23.1 | 24.6 | 25.4 | 26.0 | 32.7 | 34.2 | [1.47–2.91] | [1.28–2.64] |
EMC: ExtraMural Clinic; GHC: Group Health Cooperative; NA: not available
start program in EMC (1993)
start program in GHC (1995)
per patient per year
percentage of patients who meet the criterion
the performance of at least four measures of glycemic control including at least one HbA1c per patient per year
the performance of the combination of: (1) at least one HbA1c; (2) at least one serum cholesterol; and (3) at least one serum creatinine, per patient per year
the performance of the combination of: (1) at least four measures of glycemic control of which includes at least one HbA1c; (2) at least one serum cholesterol, and (3) at least one serum creatinine, per patient per year
all analyses were controlled for age, gender, and mode of treatment.
RR: rate ratio; OR: odds ratio; [95% CI]: 95% confidence intervals