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The effect of ‘paying for performance’ on the management of type 2 diabetes mellitus: a cross-sectional observational study

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Show simple item record O'Connor, Ray O'Driscoll, Rory O'Doherty, Jane Hannigan, Ailish O'Neill, Aoife Teljeur, Conor O'Regan, Andrew 2020-12-07T09:03:23Z 2020-12-07T09:03:23Z 2020
dc.description peer-reviewed en_US
dc.description.abstract Background: The ‘cycle of care’ (COC) pay for performance (PFP) programme, introduced in 2015, has resourced Irish GPs to provide structured care to PCRS eligible patients with type 2 diabetes mellitus (T2DM). Aim: To investigate the effect of COC on management processes. Design & setting: Cross-sectional observational study undertaken with two points of comparison (2014 and 2017) in participating practices (Republic of Ireland general practices), with comparator data from the United Kingdom National Diabetes Audit (UKNDA) 2015–2016. Method: Invitations to participate were sent to practices using a discussion forum for Health One clinical software. Participating practices provided data on the processes of care in the management of patients with T2DM. Data on PCRS eligible patients was extracted from the electronic medical record system of participating practices using secure customised software. Descriptive analysis, using IBM SPSS Statistics for Windows (version 25), was performed. Results: Of 250 practices invited, 41 practices participated (16.4%), yielding data from 3146 patients. There were substantial improvements in the rates of recording of glycosylated haemoglobin ([HbA1c] 53.1%–98.3%), total cholesterol ([TC] 59.2%–98.8%), urinary albumin:creatinine ratio ([ACR] 9.9%–42.3%), blood pressure ([BP] 61.4%–98.2%), and body-mass index ([BMI] 39.8%–97.4%) from 2014 to 2017. For the first time, rates of retinopathy screening (76.3%), foot review (64.9%), and influenza immunisation (69.9%) were recorded. Comparison of 2017 data with UKNDA 2015–2016 was broadly similar. Conclusion: The COC demonstrated much improved rates of recording of clinical and biochemical parameters, and improved achievement of targets in TC and BP, but not HbA1c. Results demonstrate substantial improvements in the processes and quality of care in the management of patients with T2DM. en_US
dc.language.iso eng en_US
dc.publisher Royal College of General Practitioners en_US
dc.relation.ispartofseries BJGP Open;pp. 1-9
dc.subject diabetes en_US
dc.subject mellitus en_US
dc.subject quality improvement en_US
dc.title The effect of ‘paying for performance’ on the management of type 2 diabetes mellitus: a cross-sectional observational study en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.3399/bjgpopen20X101021
dc.contributor.sponsor Research and Education Foundation of the Irish College of General Practitioners en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US

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