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Huber CA, Brändle M, Rapold R, et al. A set of four simple performance measures reflecting adherence to guidelines predicts hospitalization: a claims-based cohort study of patients with diabetes. Patient Prefer Adherence. 2016;10:223-31doi: 10.2147/PPA.S99895.
Huber, C. A., Brändle, M., Rapold, R., Reich, O., & Rosemann, T. (2016). A set of four simple performance measures reflecting adherence to guidelines predicts hospitalization: a claims-based cohort study of patients with diabetes. Patient preference and adherence, 10223-31. https://doi.org/10.2147/PPA.S99895
Huber, Carola A, et al. "A set of four simple performance measures reflecting adherence to guidelines predicts hospitalization: a claims-based cohort study of patients with diabetes." Patient preference and adherence vol. 10 (2016): 223-31. doi: https://doi.org/10.2147/PPA.S99895
Huber CA, Brändle M, Rapold R, Reich O, Rosemann T. A set of four simple performance measures reflecting adherence to guidelines predicts hospitalization: a claims-based cohort study of patients with diabetes. Patient Prefer Adherence. 2016 Mar 01;10:223-31. doi: 10.2147/PPA.S99895. eCollection 2016. PMID: 27042016; PMCID: PMC4780198.
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Patient Prefer Adherence. 2016 Mar 01;10:223-31. doi: 10.2147/PPA.S99895. eCollection 2016.

A set of four simple performance measures reflecting adherence to guidelines predicts hospitalization: a claims-based cohort study of patients with diabetes.

Patient preference and adherence

Carola A Huber, Michael Brändle, Roland Rapold, Oliver Reich, Thomas Rosemann

Affiliations

  1. Department of Health Sciences, Helsana Group, Zürich, Switzerland.
  2. Division of Endocrinology and Diabetes, Department of Internal Medicine, Kantonsspital St Gallen, St Gallen, Switzerland.
  3. Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland.

PMID: 27042016 PMCID: PMC4780198 DOI: 10.2147/PPA.S99895

Abstract

BACKGROUND: The link between guideline adherence and outcomes is a highly demanded issue in diabetes care. We aimed to assess the adherence to guidelines and its impact on hospitalization using a simple set of performance measures among patients with diabetes.

METHODS: We performed a retrospective cohort study, using health care claims data for adult patients with treated diabetes (2011-2013). Patients were categorized into three drug treatment groups (with oral antidiabetic agents [OAs] only, in combination with insulin, and insulin only). Performance measures were based on international established guidelines for diabetes care. Multivariate logistic regression models predicted the probability of hospitalization (2013) by adherence level (2011) among all treatment groups.

RESULTS: A total of 40,285 patients with diabetes were enrolled in 2011. Guideline adherence was quite low: about 70% of all patients received a biannual hemoglobin A1c measurement and 19.8% had undergone an annual low-density lipoprotein cholesterol test. Only 4.8% were exposed to full adherence including all performance measures (OAs: 3.7%; insulin: 7.7%; and in combination: 7.2%). Increased guideline adherence was associated with decreased probability of hospitalization. This effect was strongest in patients using OAs and insulin in combination.

CONCLUSION: Our study showed that measures to reflect physicians' guideline adherence in diabetes care can easily be calculated based on already available datasets. Furthermore, these measures are clearly linked with the probability of hospitalization suggesting that a better guideline adherence by physicians could help to prevent a large number of hospitalizations.

Keywords: adherence; antidiabetic agents; diabetes; guidelines; hospitalization; insulin

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