The Impact of Social and Clinical Complexity on Diabetes Control Measures.

Journal of the American Board of Family Medicine : JABFM
Erika K CottrellJennifer E DeVoe

Abstract

In an age of value-based payment, primary care providers are increasingly scrutinized on performance metrics that assess quality of care, including the outcomes of their patient population in key areas such as diabetes control. Although such measures often adjust for patient clinical risk factors or clinical complexity, most do not account for the social complexity of patient populations, despite research demonstrating the strong association between social factors and health. Using patient electronic health record data from 2 large community health center networks serving safety net patients, we assessed the effect of both clinical and social risk factors on poor glucose control among diabetics. Logistic regression results were used to estimate the impact of adjusting for both clinical and social complexity on provider performance metrics. Clinical complexity was measured at the patient-level using the Charlson Comorbidity Index. Social complexity was measured at the community-level using the Social Deprivation Index. Clinical complexity alone was not consistently associated with poor diabetes control (ie, HbA1c > 9%) in diabetic patients with HbA1c testing during the study period. However, increasing social complexity was sign...Continue Reading

Citations

Dec 4, 2020·Diabetes Research and Clinical Practice·Hadi JoudAbu-Sayeef Mirza
Apr 18, 2021·Canadian Journal of Diabetes·Jennifer A HersheyColin P Hawkes

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