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SDHI Diabetes Learning and Discussion day 8 th February 2005. Bruce Guthrie Tayside Centre for General Practice and on behalf of the DARTS/MEMO collaboration. Defining and measuring quality of care for people with type 2 diabetes. Qualitative study seeking to understand

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Sdhi diabetes learning and discussion day 8 th february 2005 l.jpg
SDHI Diabetes Learning and Discussion day 8th February 2005

Bruce Guthrie

Tayside Centre for General Practice and on behalf of the DARTS/MEMO collaboration


Defining and measuring quality of care for people with type 2 diabetes l.jpg
Defining and measuring quality of care for people with type 2 diabetes

  • Qualitative study seeking to understand

    • How different stakeholders define quality of care

    • What use they have for measures of aspects of care they think important

  • Quantitative study examining

    • The properties of existing measures (importance, precision, case-mix, attribution)

    • Different kinds of measure (eg measures of variation and change)

    • Ways of presenting data to serve different purposes


An evaluation of the tayside diabetes managed clinical network l.jpg
An evaluation of the Tayside diabetes managed clinical network

  • Case study of one MCN

  • Qualitative study

    • Analysis of documentary and interview data

    • Ways in which quality improvement has been pursued

    • Network forms and ways of working – hierarchies and enclaves

  • Quantitative study

    • Time series analysis of clinical process and outcome

    • ‘Intervention’ time points at area level (eg formal creation of the MCN) and practice level (eg DARTS link up)

    • Associations with measures of ‘engagement’ with network (use of DARTS/SCI-DC; uptake of education)


Future work l.jpg
Future work network

  • Developing patient surveys

    • New instruments

    • The context of use

  • Comparative research on networks

    • SDO outline application pending for multiple case studies

    • Voluntary vs mandated networks

    • Succession issues in enclave networks

    • Relationships between networks

    • Changing contexts eg new contracts, commissioning


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What about patients? network

  • We don’t know what patients want

  • Little evidence of any patient use of US report cards

  • Patient choice may not be well served by comparison against the average

  • Alternatives may be better eg other forms of league table and Dr Foster ‘nearest ten’ comparisons


Slide10 l.jpg
Context of rising numbers 1/1/98 – 1/2/05: networkType 1 diabetes 1178 → 1471 (25% increase)Type 2 diabetes 7668 → 12060 (57% increase)