The relationship of individual comorbid chronic conditions to diabetes care quality

Elizabeth Magnan, Mari Palta, Jane E. Mahoney, Nancy Pandhi, Daniel M. Bolt, Jennifer Fink, Robert T. Greenlee, Maureen A. Smith

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: Multimorbidity affects 26 million persons with diabetes, and care for comorbid chronic conditions may impact diabetes care quality. The aim of this study was to determine which chronic conditions were related to lack of achievement or achievement of diabetes care quality goals to determine potential targets for future interventions. Research design and methods: This is an exploratory retrospective analysis of electronic health record data for 23 430 adults, aged 18–75, with diabetes who were seen at seven Midwestern US health systems. The main outcome measures were achievement of six diabetes quality metrics in the reporting year, 2011 (glycated haemoglobin (HbA1c) control and testing, low-density lipoprotein control and testing, blood pressure control, kidney testing). Explanatory variables were 62 chronic condition indicators. Analyses were adjusted for baseline patient sociodemographic and healthcare utilization factors. Results: The 62 chronic conditions varied in their relationships to diabetes care goal achievement for specific care goals. Congestive heart failure was related to lack of achievement of cholesterol management goals. Obesity was related to lack of HbA1c and BP control. Mental health conditions were related to both lack of achievement and achievement of different care goals. Three conditions were related to lack of cholesterol testing, including congestive heart failure and substance-use disorders. Of 17 conditions related to achieving control goals, 16 were related to achieving HbA1c control. One-half of the comorbid conditions did not predict diabetes care quality. Conclusions: Future interventions could target patients at risk for not achieving diabetes care for specific care goals based on their individual comorbidities.

Original languageEnglish (US)
Article numbere000080
JournalBMJ Open Diabetes Research and Care
Volume3
Issue number1
DOIs
StatePublished - Jul 23 2015

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Quality of Health Care
Comorbidity
Heart Failure
Cholesterol
Electronic Health Records
Glycosylated Hemoglobin A
LDL Lipoproteins
Substance-Related Disorders
Mental Health
Research Design
Obesity
Outcome Assessment (Health Care)
Blood Pressure
Delivery of Health Care
Kidney
Health

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

The relationship of individual comorbid chronic conditions to diabetes care quality. / Magnan, Elizabeth; Palta, Mari; Mahoney, Jane E.; Pandhi, Nancy; Bolt, Daniel M.; Fink, Jennifer; Greenlee, Robert T.; Smith, Maureen A.

In: BMJ Open Diabetes Research and Care, Vol. 3, No. 1, e000080, 23.07.2015.

Research output: Contribution to journalArticle

Magnan, E, Palta, M, Mahoney, JE, Pandhi, N, Bolt, DM, Fink, J, Greenlee, RT & Smith, MA 2015, 'The relationship of individual comorbid chronic conditions to diabetes care quality', BMJ Open Diabetes Research and Care, vol. 3, no. 1, e000080. https://doi.org/10.1136/bmjdrc-2015-000080
Magnan, Elizabeth ; Palta, Mari ; Mahoney, Jane E. ; Pandhi, Nancy ; Bolt, Daniel M. ; Fink, Jennifer ; Greenlee, Robert T. ; Smith, Maureen A. / The relationship of individual comorbid chronic conditions to diabetes care quality. In: BMJ Open Diabetes Research and Care. 2015 ; Vol. 3, No. 1.
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