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Improving Diabetes Care:Effectiveness of Physician Profiling and Care Coordination by a Diabetes Resource Nurse

Baylor Scott and White Health (BSWH) logo

Baylor Scott and White Health (BSWH)

Status

Completed

Conditions

Diabetes Mellitus

Treatments

Other: Medicare Claims Feedback
Other: Diabetes Resource Nurse
Other: Medical Record Review

Study type

Interventional

Funder types

Other

Identifiers

NCT00258674
000-113

Details and patient eligibility

About

The purpose of this study is to test the effectiveness of physician profiling and care coordination by a diabetes resource nurse in improving the quality of diabetes care.

Full description

HealthTexas Provider Network primary care practices with at least 10 Medicare diabetes patients over the age of 65 were randomized to one of 3 intervention arms: physician feedback of process measures using Medicare claims data ("Claims"); feedback of Medicare claims data plus clinical measures from medical record abstraction ("Claims+MR"); or both types of feedback plus a practice-based DRN ("DRN"). For the 12 months prior to the intervention and 12 months post-intervention, performance data on diabetes related processes of care (annual HbA1c testing, annual LDL cholesterol screening, annual hypertension screening, annual eye, foot, and renal assessment) and patient outcomes (HbA1c level, LDL cholesterol level, blood pressure) were collected from medical record abstraction and Medicare claims data. Pre-post change scores will be compared between intervention arms to examine effectiveness of physician profiling and care coordination by a diabetes resource nurse.

Enrollment

1,891 patients

Sex

All

Ages

65+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • age ≥ 65 years on January 1, 2000
  • diagnosis of diabetes mellitus
  • diabetes related visit to HTPN physician within the past year
  • Resident of Texas
  • Medicare insurance coverage

Exclusion criteria

  • Patient chart not available for abstraction

Trial design

Primary purpose

Health Services Research

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

1,891 participants in 3 patient groups

Medicare Claims Feedback
Active Comparator group
Description:
Practices randomised to the Medicare Claims Feedback arm received period feedback on their performance on selected diabetes quality of care measures as reflected in the claims data for their diabetes patients.
Treatment:
Other: Medicare Claims Feedback
Medicare Claims+Medical Record Feedback
Experimental group
Description:
Practices randomised to the Medicare Claims + Medical Record Review Feedback arm received periodic feedback on their performance on selected diabetes quality of care measures as reflected in both the Medicare claims for the diabetes patients AND review/audit of their diabetes patients' medical records.
Treatment:
Other: Medical Record Review
Other: Medicare Claims Feedback
Medicare Claims+Medical Chart Review+DRN
Experimental group
Description:
In addition to the performance data from both Medicare Claims data and from review of patients' medical records, practices randomised to the Medicare Claims + Medical Record review + Diabetes Resource Nurse (DRN) had a diabetes resource nurse assigned to them, who was available to provide diabetes education and care-coordination type services for their diabetes patients.
Treatment:
Other: Diabetes Resource Nurse
Other: Medical Record Review
Other: Medicare Claims Feedback

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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