Impact of Diabetes Report Cards on Disease Control
Author Information
Author(s): Henry H. Fischer, Sheri L. Eisert, Josh M. Durfee, Susan L. Moore, Andrew W. Steele, Kevin McCullen, Katherine Anderson, Lara Penny, Thomas D. Mackenzie
Primary Institution: Denver Health and Hospital Authority
Hypothesis
Can tailored diabetes registry report cards improve disease control measures?
Conclusion
While patient report cards were well received, they did not improve clinical outcomes, but targeted feedback to providers did enhance glycemic control.
Supporting Evidence
- Patients receiving mailed report cards were less likely to present for testing for blood pressure and glycemic control.
- Provider performance feedback led to a greater increase in glycemic control compared to control clinics.
- Patient satisfaction with report cards was generally high despite no improvement in clinical outcomes.
Takeaway
The study tried to help diabetes patients by sending them report cards, but it didn't really make them healthier; however, giving doctors specific feedback did help some patients.
Methodology
A nested randomized trial involving 5,457 low-income adults with diabetes across eight clinics, comparing mailed report cards and provider feedback.
Potential Biases
Differences in race/ethnicity among clinic groupings may introduce bias.
Limitations
The study faced challenges in detecting performance changes at the clinic level and had a low survey response rate.
Participant Demographics
Participants were primarily low-income adults with diabetes, many uninsured (43%), on Medicaid (18%), or Medicare (26%), with a majority being Latino (59%) and a significant African-American minority (21%).
Statistical Information
P-Value
p < 0.001
Confidence Interval
CI -0.131 - -0.077
Statistical Significance
p < 0.001
Digital Object Identifier (DOI)
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