Auditing chronic disease care: Does it make a difference?

Area of Science:

• Public Health
• Healthcare Management
• Quality Improvement

Background:

• An integrated audit tool for diabetes, hypertension, asthma, COPD, and epilepsy was implemented in South Africa's Western Cape Province.
• Annual audits commenced in 2009, with all six districts participating by 2012.

Purpose of the Study:

• To evaluate the impact of clinical audits on chronic disease care within health districts.
• To determine if sustained participation in audits leads to improved healthcare quality over time.

Main Methods:

• Internal audits assessed primary healthcare facility processes and equipment.
• Folder reviews of 10 patient records per condition per facility were conducted using random systematic sampling.
• Comparative analysis contrasted districts with long-term audit participation ('2012 old') versus recent participation ('2012 new').

Main Results:

• The number of audited facilities increased significantly from 29 (2009) to 129 (2012).
• Districts with longer audit history ('2012 old') showed improvements compared to newly participating districts ('2012 new').
• Newly participating districts were less likely to record clinical processes (OR 0.25, 95% CI 0.21-0.31).

Conclusions:

• Sustained clinical audits are valuable for enhancing chronic disease care processes.
• Long-term audit participation correlates with improved healthcare quality.
• The study suggests audits contribute to better patient outcomes through process improvements.