The impact of concordant and discordant comorbidities on patient-assessed quality of diabetes care

Aung, Eindra, Donald, Maria, Coll, Joseph, Dower, Jo, Williams, Gail M. and Doi, Suhail A. R. (2013) The impact of concordant and discordant comorbidities on patient-assessed quality of diabetes care. Health Expectations, 18 5: 1621-1632. doi:10.1111/hex.12151

Author Aung, Eindra
Donald, Maria
Coll, Joseph
Dower, Jo
Williams, Gail M.
Doi, Suhail A. R.
Title The impact of concordant and discordant comorbidities on patient-assessed quality of diabetes care
Journal name Health Expectations   Check publisher's open access policy
ISSN 1369-6513
Publication date 2013-10-24
Year available 2013
Sub-type Article (original research)
DOI 10.1111/hex.12151
Open Access Status DOI
Volume 18
Issue 5
Start page 1621
End page 1632
Total pages 12
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Objective To examine the impact of concordant and discordant comorbidities on patients’ assessments of providers’ adherence to diabetes-specific care guidelines and quality of chronic illness care.
Research design and methods A population-based survey of 3761 adults with type 2 diabetes, living in Queensland, Australia was conducted in 2008. Based on self-reports, participants were grouped into four mutually exclusive comorbid categories: none, concordant only, discordant only and both concordant and discordant. Outcome measures included patient-reported providers’ adherence to guideline-recommended care and the Patient Assessment of Chronic Illness Care (PACIC), which measures care according to the Chronic Care Model. Analyses using the former measure included logistic regressions, and the latter measure included univariate analysis of variance, both unadjusted and adjusted for sampling region, gender, age, educational attainment, diabetes duration and treatment status.
Results Having concordant comorbidities increased the odds of patient-reported providers’ adherence for 7 of the 11 guideline-recommended care activities in unadjusted analyses. However, the effect remained significant for only two provider activities (reviews of medication and/or complications and blood pressure examinations) when adjusted. A similar pattern was found for the both concordant and discordant comorbidity category. The presence of discordant comorbidities influenced only one provider activity (blood pressure examinations). No association between comorbidity type and the overall PACIC score was found.
Conclusions Comorbidity type is associated with diabetes-specific care, but does not seem to influence broader aspects of chronic illness care directly. Providers need to place more emphasis on care activities which are not comorbidity-specific and thus transferable across different chronic conditions.
Keyword Chronic illness care
Guideline adherence
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online 24 October 2013

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 17 Mar 2014, 20:24:05 EST by Nyree Divitini on behalf of Health LinQ