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Am J Public Health. 2000 March; 90(3): 431–434.
PMCID: PMC1446172

Quality of diabetes care in community health centers.


OBJECTIVES: This study assessed the quality of diabetes care in community health centers. METHODS: In 55 midwestern community health centers, we reviewed the charts of 2865 diabetic adults for American Diabetes Association measures of quality. RESULTS: On average, 70% of the patients in each community health center had measurements of glycosylated hemoglobin, 26% had dilated eye examinations, 66% had diet intervention, and 51% received foot care. The average glycosylated hemoglobin value per community health center was 8.6%. Practice guidelines were independently associated with higher quality of care. CONCLUSIONS: Rates of adherence to process measures of quality were relatively low among community health centers, compared with the targets established by the American Diabetes Association.

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Selected References

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  • Rosenbaum S, Hawkins DR, Jr, Rosenbaum E, Blake S. State funding of comprehensive primary medical care service programs for medically underserved populations. Am J Public Health. 1998 Mar;88(3):357–363. [PMC free article] [PubMed]
  • Wylie-Rosett J, Basch C, Walker EA, Zybert P, Shamoon H, Engel S, Cypress M. Ophthalmic referral rates for patients with diabetes in primary-care clinics located in disadvantaged urban communities. J Diabetes Complications. 1995 Jan-Mar;9(1):49–54. [PubMed]
  • Wylie-Rosett J, Walker EA, Shamoon H, Engel S, Basch C, Zybert P. Assessment of documented foot examinations for patients with diabetes in inner-city primary care clinics. Arch Fam Med. 1995 Jan;4(1):46–50. [PubMed]
  • Walker EA, Wylie-Rosett J, Shamoon H, Engel S, Basch CE, Zybert P, Cypress M. Program development to prevent complications of diabetes. Assessment of barriers in an urban clinic. Diabetes Care. 1995 Sep;18(9):1291–1293. [PubMed]
  • Miller KL, Hirsch IB. Physicians' practices in screening for the development of diabetic nephropathy and the use of glycosylated hemoglobin levels. Diabetes Care. 1994 Dec;17(12):1495–1497. [PubMed]
  • Peters AL, Legorreta AP, Ossorio RC, Davidson MB. Quality of outpatient care provided to diabetic patients. A health maintenance organization experience. Diabetes Care. 1996 Jun;19(6):601–606. [PubMed]
  • Mayfield JA, Rith-Najarian SJ, Acton KJ, Schraer CD, Stahn RM, Johnson MH, Gohdes D. Assessment of diabetes care by medical record review. The Indian Health Service model. Diabetes Care. 1994 Aug;17(8):918–923. [PubMed]
  • Chin MH, Zhang JX, Merrell K. Diabetes in the African-American Medicare population. Morbidity, quality of care, and resource utilization. Diabetes Care. 1998 Jul;21(7):1090–1095. [PubMed]
  • Weiner JP, Parente ST, Garnick DW, Fowles J, Lawthers AG, Palmer RH. Variation in office-based quality. A claims-based profile of care provided to Medicare patients with diabetes. JAMA. 1995 May 17;273(19):1503–1508. [PubMed]
  • Hiss RG, Anderson RM, Hess GE, Stepien CJ, Davis WK. Community diabetes care. A 10-year perspective. Diabetes Care. 1994 Oct;17(10):1124–1134. [PubMed]
  • Peterson KA. Diabetes care by primary care physicians in Minnesota and Wisconsin. J Fam Pract. 1994 Apr;38(4):361–367. [PubMed]
  • Starfield B, Powe NR, Weiner JR, Stuart M, Steinwachs D, Scholle SH, Gerstenberger A. Costs vs quality in different types of primary care settings. JAMA. 1994 Dec 28;272(24):1903–1908. [PubMed]
  • Mohr JJ, Mahoney CC, Nelson EC, Batalden PB, Plume SK. Improving health care, Part 3: Clinical benchmarking for best patient care. Jt Comm J Qual Improv. 1996 Sep;22(9):599–616. [PubMed]
  • Deeb LC, Pettijohn FP, Shirah JK, Freeman G. Interventions among primary-care practitioners to improve care for preventable complications of diabetes. Diabetes Care. 1988 Mar;11(3):275–280. [PubMed]
  • Oxman AD, Thomson MA, Davis DA, Haynes RB. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice. CMAJ. 1995 Nov 15;153(10):1423–1431. [PMC free article] [PubMed]
  • Feder G, Griffiths C, Highton C, Eldridge S, Spence M, Southgate L. Do clinical guidelines introduced with practice based education improve care of asthmatic and diabetic patients? A randomised controlled trial in general practices in east London. BMJ. 1995 Dec 2;311(7018):1473–1478. [PMC free article] [PubMed]
  • Ellrodt G, Cook DJ, Lee J, Cho M, Hunt D, Weingarten S. Evidence-based disease management. JAMA. 1997 Nov 26;278(20):1687–1692. [PubMed]
  • O'Connor PJ, Rush WA, Peterson J, Morben P, Cherney L, Keogh C, Lasch S. Continuous quality improvement can improve glycemic control for HMO patients with diabetes. Arch Fam Med. 1996 Oct;5(9):502–506. [PubMed]

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