Background: Hemoglobin A1c (HbA1c) results are generally reviewed several days after office visits. The clinical decisions on elevated HbA1cs may be complex and are rarely urgent. Providers may elect to defer the decision or its implementation to a future clinical encounter.Objective: To determine the occurrence rate, predictors, and eventual decision outcomes for HbA1c deferred decisions.Design: Provider questionnaire completed when HbA1c results from type 2 diabetes patients were reviewed, followed by a chart review on deferred cases 6 months later.Participants: Providers at 19 Colorado primary care clinics. Measurements: For HbA1c >7%, whether the decision or its implementation was deferred. In deferred cases, whether a clinical decision was eventually made.Results: Of the 311 HbA1cs >7%, 31 (10.0%) had deferred decisions. In multivariate analysis, deferred decisions were more likely in African Americans (odds ratio [OR] 4.91, 95% CI 1.81, 13.3) and less likely when the patient's usual provider reviewed the HbA1c (OR 0.40, 95% CI 0.18, 0.90). In the chart review, for deferred cases (n ‫؍‬ 18), a clinical decision was made in 14 cases, usually at the next clinical encounter. In 4 cases, the HbA1c was never addressed.

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Scientists studying people with multiple chronic conditions (MCC) need new datasets and research methods to help them examine this growing population. The MCC Research Network data archive (http://www.icpsr.umich.edu/AHRQMCC/) from the Agency for Healthcare Research and Quality (AHRQ) seeks to fill this gap. Using datasets freely available in the data archive, researchers can investigate the interactions of chronic conditions, compare outcomes from different treatments, and discover the most efficient and effective methods of treating patients with MCC. Find Data AHRQ's MCC Research Network data archive provides freely available datasets and documentation as well as additional MCC-related data. Data come from a rich range of sources, including: electronic medical record clinical data, multi-payer claims data, chronic disease registries, Medicaid claims, state psychiatric hospital inpatient data and outpatient mental health services, self-reported home blood sugar and blood pressure data, state cancer registry data, and qualityof-life and physical assessment data obtained from computer-assisted interviews. For many datasets in the archive, researchers can search for variables, studies, and bibliographies, as well as download data in SPSS, SAS, Stata, and ASCII formats.