Statewide Evaluation of Measuring Physician Delivery of Self-Management Support in Chronic Disease Care

Sequist, Thomas D.; Glahn, Ted von; Li, Angela; Rogers, William H.; Safran, Dana Gelb

doi:10.1007/s11606-009-1033-6

Cited by 13 publications

(11 citation statements)

References 26 publications

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“…The quality of the patient experience we observed in our study is much lower compared to studies of diabetic patient experience in private physician practices (Sequist et al. , ). Understanding how to improve patient experiences among patients with diverse language preferences may aid in the survival, growth, and competitive advantage of CHCs in the post‐ACA era.…”

Section: Discussioncontrasting

confidence: 89%

“…As the Affordable Care Act (ACA) enables greater patient choice of where to seek care, patient retention is critical to the survival of CHCs, where there have historically been high levels of patient turnover. The quality of the patient experience we observed in our study is much lower compared to studies of diabetic patient experience in private physician practices (Sequist et al 2009(Sequist et al , 2012. Understanding how to improve patient experiences among patients with diverse language preferences may aid in the survival, growth, and competitive advantage of CHCs in the post-ACA era.…”

Section: Discussionmentioning

confidence: 57%

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Disparities in Diabetes Care Quality by English Language Preference in Community Health Centers

Leung¹,

Bustamante

Martínez

et al. 2016

Health Services Research

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Objective. To conduct a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference. Study Setting/Data Collection. Clinical outcomes (2011) and patient survey data (2012) for Type 2 diabetes adults from 14 CHCs (n = 1,053). Study Design. We estimated separate regression models for Latino and Asian patients by English language preference for Clinician & Group-Consumer Assessment of Healthcare Providers and System, Patient Assessment of Chronic Illness Care, hemoglobin A1c, and self-reported hypoglycemic events. We used the Blinder-Oaxaca decomposition method to parse out observed and unobserved differences in outcomes between English versus non-English language groups. Principal Findings. After adjusting for socioeconomic and health characteristics, disparities in patient experiences by English language preference were found only among Asian patients. Unobserved factors largely accounted for linguistic disparities for most patient experience measures. There were no significant differences in glycemic control by language for either Latino or Asian patients. Conclusions. Given the importance of patient retention in CHCs, our findings indicate opportunities to improve CHC patients' experiences of care and to reduce disparities in patient experience by English preference for Asian diabetes patients.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 57%

Disparities in Diabetes Care Quality by English Language Preference in Community Health Centers

Leung¹,

Bustamante

Martínez

et al. 2016

Health Services Research

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“…Conceptual analysis allowed to realize that when it comes to self-management in health, the word "self-management" is more often used in the discipline of Medicine (3)(4)(7)(8)10,(12)(13)(14)(15)(16)19) . In the area of Nursing (11,18) , especially in Brazil, the term self-care is used in the searched databases.…”

Section: Resultsmentioning

confidence: 99%

“…It is recommended that the multidisciplinary health care team monitors and encourages efficient care strategies, associated with conventional treatment, for this benefits the patient and the management of the program. Thus, it becomes clear that the patient should get involved in the management of the disease, knowledge and control of high blood pressure (10,19) .…”

Section: Consequences Of Self-management Of Hypertensive Individualsmentioning

confidence: 99%

Análise conceitual de autogestão do indivíduo hipertenso

Balduino

Mantovani

Lacerda

et al. 2013

Rev. Gaúcha Enferm.

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This research aimed to analyze the concept of self-management of hypertensive individuals. Theoretical and documentary study based on Walker and Avant's conceptual analysis by means of the Scientific Electronic Library Brazil and the Medical Literature Analysis and Retrieval System Online in the Coordination for Higher Education Personnel Development (CAPES, in Portuguese) and the National Library of Medicine websites. Fourteen (14) articles and one (1) thesis were selected and reviewed, in Portuguese and English, in the period January 2007 to September 2012. Background: missing doctor's appointments, non-compliance to blood pressure control treatment, to recommendations to proper diet standards and stress. Attributes: blood pressure control and disease management. Consequences: home monitoring of blood pressure with control improvement, accomplishment of disease management, compliance and sharing of the creation process of self-management goals and caring activities by the interdisciplinary team through individualized actions. It was concluded that the self-management concept is a dynamic, active process which requires knowledge, attitude, discipline, determination, commitment, self-regulation, empowerment and self-efficiency in order to manage the disease and achieve healthy living.Descriptors: Disease management. Hypertension. Chronic disease. Nursing. RESUMO Objetivou analisar conceito de autogestão do indivíduo hipertenso. Estudo teórico pautado na análise conceitual Walker e Avant mediante as bases de dados Scientific Electronic Library Brazil e Medical RESUMEN Desarrollar análisis del concepto de autogestión relacionado a la hipertensión. Estudio teórico pautado en el análisis conceptual Walker y Avant a través de la búsqueda en las bases de datos Scientific Electronic Library Brasil y Medical Literature Analysis and Retrievel

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“…Patient-reported outcomes included the 12-item short-form health survey (SF-12v2) of quality of life (QoL) [13]; and the diabetes-related QoL (DQoL-Brief) survey [14]. Participant satisfaction with care was measured at follow-up using the eight-item client satisfaction questionnaire (CSQ-8) [15] and a five-item participant assessment of selfmanagement support [16]. Questionnaire data were available for 274 (90%) participants at baseline, 210 (69%) at 6 months and 187 (61%) at 12 months.…”

Section: Methodsmentioning

confidence: 99%

Clinical outcomes of an integrated primary–secondary model of care for individuals with complex type 2 diabetes: a non-inferiority randomised controlled trial

et al. 2018

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Aims/hypothesis The aim of the study was to determine if a Beacon model of integrated care utilising general practitioners (GPs) with special interests could achieve similar clinical outcomes to a hospital-based specialist diabetes outpatient clinic. Methods This pragmatic non-inferiority multisite randomised controlled trial assigned individuals with complex type 2 diabetes to care delivered by a Beacon clinic or to usual care delivered by a hospital outpatient department, in a 3:1 ratio. Owing to the nature of the study, researchers were only blinded during the allocation process. Eligible participants were aged 18 or over, had been referred by their usual GP to the hospital central referral hub with type 2 diabetes and had been triaged to be seen within 30 or 90 days. The intervention consisted of diabetes management in primary care by GPs with a special interest who had been upskilled in complex diabetes under the supervision of an endocrinologist. The primary outcome was HbA 1c at 12 months postrecruitment. The non-inferiority margin was 4.4 mmol/mol (0.4%). Both per-protocol and intention-to-treat analyses are reported. Results Between 27 November 2012 and 14 July 2015, 352 individuals were recruited and 305 comprised the intention-to-treat sample (71 in usual care group and 234 in the Beacon model group). The Beacon model was non-inferior to usual care for both the per-protocol (difference −0.38 mmol/mol [95% CI −4.72, 3.96]; −0.03% [95% CI −0.43, 0.36]) and the intention-to-treat (difference −1.28 mmol/mol [95% CI −5.96, 3.40]; −0.12% [95% CI −0.55, 0.31]) analyses. Non-inferiority was sustained in a sensitivity analysis at 12 months. There were no statistically or clinically significant differences in the secondary outcomes of BP, lipids or quality of life as measured by the 12 item short-form health survey (SF-12v2) and the diabetes-related quality of life (DQoL-Brief) survey. Safety indicators did not differ between groups. Participant satisfaction on the eight-item client satisfaction questionnaire (CSQ-8) was good in both groups, but scores were significantly higher in the Beacon model group than the usual care group (mean [SD] 28.4 [4.9] vs 25.6 [4.9], respectively, p < 0.001). Conclusions/interpretation In individuals with type 2 diabetes, a model of integrated care delivered in the community by GPs with a special interest can safely achieve clinical outcomes that are not inferior to those achieved with gold-standard hospitalbased specialist outpatient clinics. Individuals receiving care in the community had greater satisfaction. Further studies will determine the cost of delivering this model of care.

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Statewide Evaluation of Measuring Physician Delivery of Self-Management Support in Chronic Disease Care

Abstract: Measurement of self-management support is feasible and can identify gaps in care not currently included in standard measures of patient care experiences.

Cited by 13 publications

References 26 publications

Disparities in Diabetes Care Quality by English Language Preference in Community Health Centers

Disparities in Diabetes Care Quality by English Language Preference in Community Health Centers

Análise conceitual de autogestão do indivíduo hipertenso

Clinical outcomes of an integrated primary–secondary model of care for individuals with complex type 2 diabetes: a non-inferiority randomised controlled trial

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