Table 2.
Processes of Care and Outcome Measures by Year
| Process of Care | Percentage in 1998* | Percentage in 2002† |
|---|---|---|
| At least one HbA1c | 71 | 92 |
| Lipid assessment | 52 | 70 |
| Microalbumin assessment | 15 | 44 |
| Eye exam or referral | 25 | 44 |
| Foot exam or referral | 31 | 63 |
| ACE inhibitor | 33 | 55 |
| Aspirin | 22 | 45 |
| Insulin alone (observed) | 17 | 12 |
| Insulin and oral therapy (observed) | 12 | 16 |
| Oral glucose-lowering therapy alone (observed) | 61 | 64 |
| Outcome Measure | Mean (Standard Deviation), 1998 | Mean Difference between 1998 and 2002 (95% Confidence Intervals)‡ |
| HbA1c (%) | 8.53 (2.14) | −0.45 (−0.72, −0.17) |
| Total cholesterol (mg/dl) | 212 (55) | −13.5 (−20.4, −6.7) |
| LDL cholesterol (mg/dl) | 127 (51) | −19.7 (25.8, −13.6) |
| HDL cholesterol (mg/dl) | 47 (36) | −6.4 (−16.9, 4.0) |
| Systolic blood pressure (mmHg) | 133 (19) | −1.81 (−4.03, 0.40) |
| Diastolic blood pressure (mmHg) | 79 (11) | −0.79 (−1.98, 0.40) |
Estimated rate from univariate mixed logistic regression that incorporates correlation due to clustering of patients within HCs.
Estimated from multivariate mixed logistic regression that adjusts for covariates and incorporates correlation due to clustering of patients within HCs.
Three-level hierarchical regression of patient-level outcomes on year, with health center and year within health center as random effects, controlling for region (Midwest, West Central) and Diabetes Collaborative (I, II). Candidate covariates: urban versus rural location, age, sex, race, insulin treatment, comorbidities, and complications of diabetes (hypertension, myocardial infarction, peripheral vascular disease, retinopathy, neuropathy, and renal failure).
HCs, health centers