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Comparison of 2 systems for clinical practice profiling in diabetic care: medical records versus claims and

J Ross Maclean1, Donna M Fick, Wayne K Hoffman

  • 1Department of Medicine, Medical College of Georgia, Augusta 30912, USA. rmaclean@mail.mcg.edu

The American Journal of Managed Care
|February 21, 2002
PubMed

Insights

Glycosylated hemoglobin (HbA1c) testing and control rates were evaluated in primary care. Academic medical centers showed higher HbA1c testing rates than health maintenance organizations, highlighting data system challenges.

Area of Science:

  • Diabetes Mellitus Management
  • Healthcare Quality Measurement
  • Clinical Practice Profiling

Background:

  • Glycosylated hemoglobin (HbA1c) is a key marker for diabetes mellitus control.
  • Accurate measurement of HbA1c testing and control rates is crucial for assessing healthcare quality.
  • Discrepancies in data collection between healthcare systems can impact performance measurement.

Purpose of the Study:

  • To determine the rate of HbA1c testing and control in an academic medical center primary care clinic.
  • To compare HbA1c testing data between an academic medical center and a health maintenance organization for a shared patient cohort.
  • To identify challenges in accurately profiling clinical practice based on available data.

Main Methods:

  • Retrospective analysis of medical records, claims, and administrative data.
  • Review of 300 patient records with diabetes mellitus from an academic medical center.
  • Adherence to National Committee for Quality Assurance guidelines for data collection.

Main Results:

  • 91.7% of patients at the academic medical center had documented HbA1c tests.
  • 74.9% of tested patients achieved good glycemic control (HbA1c ≤ 9.5%).
  • HbA1c testing rates were significantly higher at the academic medical center (92.7%) compared to the HMO (36.3%) based on claims data.

Conclusions:

  • Administrative and claims data systems have limitations for accurate performance measurement.
  • Sole reliance on medical record review for quality assessment is resource-intensive.
  • Integrated data tracking across healthcare systems is necessary for comprehensive quality reporting.
Abstract

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