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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
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
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
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
Future work
  • 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
what about patients
What about patients?
  • 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
Context of rising numbers 1/1/98 – 1/2/05: Type 1 diabetes 1178 → 1471 (25% increase)Type 2 diabetes 7668 → 12060 (57% increase)