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Quality improvements affect care for chronic conditions

National quality improvement interventions aimed at patients with diabetes, hypertension, and asthma improved the quality-of-care processes in health centers but did not improve intermediate clinical outcomes, according to a Feb 28, 2007, news release from the Agency for Healthcare Research and Quality. In a study of 9,658 patients at 44 health care centers in the United States, researchers analyzed the effect of implementing quality improvement interventions (eg, the use of tests or medications) related to diabetes, hypertension, and asthma on quality of care delivered to patients and their clinical outcomes.

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Researchers reviewed medical records at the study health care centers and compared quality measures from a one-year period before and a one-year period after the interventions were instituted. They also compared the quality measures at these facilities with those found at external control centers. Process improvements that occurred in the study centers included a

* 21% increase in foot examinations for patients with diabetes,

* 14% increase in the use of anti-inflammatory medication for patients with asthma,

* 16% increase in the [eve[ of screening tests for glycated hemoglobin in patients with diabetes mellitus,

* 6% improvement in processes of care related to screening and disease prevention for art three conditions, and

* 5% improvement in processes related to disease monitoring and treatment for art three conditions. Despite these improvements, however, researchers found no improvement in intermediate outcomes, including

* control of glycated hemoglobin in patients with diabetes;

* control of brood pressure levels in patients with hypertension; and

* reduction of urgent care visits, emergency room visits, or hospitalization for patients with asthma.

Chronic Disease Management Quality Improvement Efforts Yield Better Care Delivery [news release]. Rockville, Md: Agency for Healthcare Research and Quality; February 28, 2007.

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Quality improvements affect care for chronic conditions

AORN Journal, May, 2007

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