Assessing quality of diabetes care and its variation in Aboriginal community health centres in Australia

Si, Damin, Bailie, Ross, Dowden, Michelle, Kennedy, Catherine, Cox, Rhonda, O'Donoghue, Lynette, Liddle, Helen, Kwedza, Ru, Connors, Christine, Thompson, Sandra, Burke, Hugh, Brown, Alex and Weeramanthri, Tarun (2010) Assessing quality of diabetes care and its variation in Aboriginal community health centres in Australia. Diabetes/Metabolism Research and Reviews, 26 6: 464-473. doi:10.1002/dmrr.1062

Author Si, Damin
Bailie, Ross
Dowden, Michelle
Kennedy, Catherine
Cox, Rhonda
O'Donoghue, Lynette
Liddle, Helen
Kwedza, Ru
Connors, Christine
Thompson, Sandra
Burke, Hugh
Brown, Alex
Weeramanthri, Tarun
Title Assessing quality of diabetes care and its variation in Aboriginal community health centres in Australia
Journal name Diabetes/Metabolism Research and Reviews   Check publisher's open access policy
ISSN 1520-7552
Publication date 2010-09-01
Sub-type Article (original research)
DOI 10.1002/dmrr.1062
Volume 26
Issue 6
Start page 464
End page 473
Total pages 10
Place of publication West Sussex, United Kingdom
Publisher John Wiley & Sons
Language eng
Subject C1
1103 Clinical Sciences
Formatted abstract
Background: Examining variation in diabetes care across regions/organizations provides insight into underlying factors related to quality of care. The aims of this study were to assess quality of diabetes care and its variation among Aboriginal community health centres in Australia, and to estimate partitioning of variation attributable to health centre and individual patient characteristics.

Method: During 2005-2009, clinical medical audits were conducted in 62 Aboriginal community health centres from four states/territories. Main outcome measures include adherence to guidelines-scheduled processes of diabetes care, treatment and medication adjustment, and control of HbA(1c), blood pressure, total cholesterol and albumin/creatinine ratio (ACR).

Wide variation was observed across different categories of diabetes care measures and across centres: (1) overall adherence to delivery of services averaged 57% (range 22-83% across centres); (2) medication adjustment rates after elevated HbA1c: 26% (0-72%); and (3) proportions of patients with HbA1c < 7%: 27% (0-55%); with blood pressure < 130/80 mmHg: 36%(0-59%). Health centre level characteristics accounted for 36% of the total variation in adherence to process measures, and 3-11% of the total variation in patient intermediate outcomes; the remaining, substantial amount of variation in each measure was attributable to patient level characteristics.

Deficiencies in a range of quality of care measures provide multiple opportunities for improvement. The majority of variation in quality of diabetes care appears to be attributable to patient level characteristics. Further understanding of factors affecting variation in the care of individuals should assist clinicians, managers and policy makers to develop strategies to improve quality of diabetes care in Aboriginal communities.
(C) 2010 John Wiley & Sons, Ltd.
Keyword Diabetes mellitus type 2
Quality of care
Variation of care
Aboriginal populations
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
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Created: Sun, 17 Oct 2010, 10:14:40 EST