Diabetes Care Improvement

Chronic disease is believed to account for a substantial chunk of health care spending.  Therefore, a lot of effort has gone into improving the care for patients with those diseases, with a variety of guidelines for care and initiatives to improve adherence to recommended care.  Public reporting, pay-for-performance and other mechanisms are being used to encourage providers to manage these chronic disease patients effectively.  Research reported in the New England Journal Medicine examines the state of care for diabetes patients from the years 1999 to 2010.   (NEJM Article)    The research was based on survey data and found that overall the number of patients meeting goals for glycemic control increased by almost 8%, those meeting blood pressure targets increased 11.7%, and there was over a 20% increase in patients meeting cholesterol control guidelines.  Tobacco use did not change significantly.  But only 13% of patients met targets for all care guidelines and between 30% and 50% of patients were not meeting an individualized care target.  Younger patients show worse adherence and have not shown improvement over time in meeting goals.  The research suggests that while there are some improvements in care processes and perhaps in actual outcomes, there is a lot of room for improvement and that current strategies may not be adequate to achieve that improvement.