Table 4.
Measures | CHC | FFS | FHN | HSO | PValue |
Process measures | |||||
Diabetes, % | |||||
Foot examination documented in previous 2 y | 63 | 29 | 39 | 39 | <.001a |
Eye examination in previous 2 y | 61 | 44 | 38 | 37 | .005a |
ACEI/ARB in previous 2 y | 71 | 64 | 65 | 73 | .536a |
2 HbA1c tests in previous 1 y | 73 | 57 | 54 | 48 | .007a |
Overall diabetes score | 69 | 52 | 53 | 54 | <.001b |
Coronary artery disease, % | |||||
Aspirin documented in previous 2 y | 80 | 75 | 72 | 75 | .81a |
β-Blocker documented in previous 2 y | 80 | 67 | 62 | 73 | .18a |
Statin documented in previous 2 y | 76 | 81 | 64 | 76 | .14a |
Overall coronary artery disease score | 79 | 74 | 66 | 75 | .11b |
Congestive heart failure, % | |||||
ACEI/ARB in previous 2 y | 63 | 93 | 93 | 84 | .17a |
β-Blocker in previous 2 y | 50 | 47 | 47 | 68 | .51a |
Overall congestive heart failure score | 56 | 70 | 70 | 76 | .56b |
Overall chronic disease management score, % | |||||
Total score, mean | 72 | 61 | 60 | 64 | .003b |
Unadjusted difference in scorec | Ref | −11d | −12e | −8f | |
Adjusted difference in scoreg | Ref | −13e | −15e | −10d | |
Outcome measures: intermediate clinical outcome | |||||
Diabetes | |||||
Target HbA1c, %h | 56 | 54 | 61 | 55 | .83a |
Last HbA1c level, mean % | 7.3 | 7.1 | 6.8 | 7.2 | .23b |
Hypertension | |||||
Target blood pressure, %i | 38 | 40 | 39 | 44 | .65a |
Systolic blood pressure, mean, mm Hg | 138j | 135.2 | 137 | 135.3 | .055b |
Diastolic blood pressure, mean, mm Hg | 81.2j | 80.4k | 80.1k | 76.7 | .007b |
ACEI/ARB = antiotensin-converting enzyme inhibitors/antiotensin receptor blockers; CHC = community health center; FFS = fee for service; FHN = family health network; HbA1c = hemoglobin A1c; HSO = health service organization.
Note: Values, unless otherwise stated, are expressed as percentage of charts on which the individual manoeuvre was noted.
aGenerated from contingency table using Pearson χ2 statistic.
bGenerated with analysis of variance.
cResult of regression analysis with only model dummy variables.
dP <.01 compared with CHC as reference.
eP <.001 compared with CHC as reference.
fP <.05 compared with CHC as a reference.
gResult of regression analysis with model dummy variables and adjusted for patient age and sex.
hPercentage of patients with HbA1c ≤ 7.0
iPercentage of patients with average target blood pressure in previous 6 months. Target blood pressure was 130/80 mm Hg for patients with diabetes and 140/90 mm Hg for all others.
jP <.05 compared to HSO as reference.
kP <.001 compared to HSO as reference.