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SDHI Diabetes Learning and Discussion day 8 th February 2005

SDHI Diabetes Learning and Discussion day 8 th February 2005. Bruce Guthrie Tayside Centre for General Practice and on behalf of the DARTS/MEMO collaboration. Defining and measuring quality of care for people with type 2 diabetes. Qualitative study seeking to understand

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SDHI Diabetes Learning and Discussion day 8 th February 2005

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  1. SDHI Diabetes Learning and Discussion day 8th February 2005 Bruce Guthrie Tayside Centre for General Practice and on behalf of the DARTS/MEMO collaboration

  2. Defining and measuring quality of care for people with type 2 diabetes • Qualitative study seeking to understand • How different stakeholders define quality of care • What use they have for measures of aspects of care they think important • Quantitative study examining • The properties of existing measures (importance, precision, case-mix, attribution) • Different kinds of measure (eg measures of variation and change) • Ways of presenting data to serve different purposes

  3. An evaluation of the Tayside diabetes managed clinical network • Case study of one MCN • Qualitative study • Analysis of documentary and interview data • Ways in which quality improvement has been pursued • Network forms and ways of working – hierarchies and enclaves • Quantitative study • Time series analysis of clinical process and outcome • ‘Intervention’ time points at area level (eg formal creation of the MCN) and practice level (eg DARTS link up) • Associations with measures of ‘engagement’ with network (use of DARTS/SCI-DC; uptake of education)

  4. Future work • Developing patient surveys • New instruments • The context of use • Comparative research on networks • SDO outline application pending for multiple case studies • Voluntary vs mandated networks • Succession issues in enclave networks • Relationships between networks • Changing contexts eg new contracts, commissioning

  5. What about patients? • We don’t know what patients want • Little evidence of any patient use of US report cards • Patient choice may not be well served by comparison against the average • Alternatives may be better eg other forms of league table and Dr Foster ‘nearest ten’ comparisons

  6. Context of rising numbers 1/1/98 – 1/2/05: Type 1 diabetes 1178 → 1471 (25% increase)Type 2 diabetes 7668 → 12060 (57% increase)

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