The impact of a diabetes local enhanced service on quality outcome framework diabetes outcomes

Sopna Choudhury, Shakir Hussain, Guiqing Yao, Jill Hill, Waqar Malik, Shahrad Taheri

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The rising challenge of diabetes requires novel service delivery approaches. In the UK, Local Enhanced Services (LES) have been commissioned for diabetes. Health professionals from general practices (GPs) who signed up to LES were given additional training (and a monetary incentive) to improve management of patients with diabetes. All practices in the PCT were invited to the LES initiative, which ensured avoiding selection bias. The aim of the study was to examine the impact of LES in terms of diabetes Quality Outcome Framework (QOF) indicators: DM23(glycaemia), DM17(lipid) and DM12(blood pressure; BP). Methods: QOF diabetes indicators were examined using data from 76 general practices for 2009-2010 in a large primary care trust area in Birmingham, UK. Data were extracted from Quality Management Analysis System. The primary outcome was a difference in achievement of QOF indicators between LES and NLES practices. A secondary outcome was the difference between LES and non-LES practices for hospital first and follow-up appointments. Results: We did not find any difference for DM12(BP) and DM17(lipid) outcomes between LES and NLES practices. However, LES practices were more likely to achieve the DM23(glycaemia) outcome (estimated odds 1.459;95% CI: 1.378-1.544; P=0.0001). The probability of achieving satisfactory level of DM23(glycaemia) increased by almost 10% when GPs belonged to LES groups compared with GPs in NLES group. LES practices were less likely to refer patients to secondary care. Conclusion: Overall, LES practices performed better in the achievement of DM23(glycaemia) and also referred fewer patients to hospital, thereby meeting their objectives. This suggests that the LES approach is beneficial and needs to be further explored in order to ascertain whether the impact exerted was due to LES.

Original languageEnglish
Article numbere83738
JournalPLoS One
Volume8
Issue number12
DOIs
Publication statusPublished - 17 Dec 2013

Fingerprint

Medical problems
General Practice
diabetes
blood glucose
Lipids
Secondary Care
Professional Practice
Selection Bias
Blood pressure
Quality management
Motivation
health care workers
Primary Health Care
lipids
Appointments and Schedules
blood pressure
Blood Pressure
Health

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

The impact of a diabetes local enhanced service on quality outcome framework diabetes outcomes. / Choudhury, Sopna; Hussain, Shakir; Yao, Guiqing; Hill, Jill; Malik, Waqar; Taheri, Shahrad.

In: PLoS One, Vol. 8, No. 12, e83738, 17.12.2013.

Research output: Contribution to journalArticle

Choudhury, Sopna ; Hussain, Shakir ; Yao, Guiqing ; Hill, Jill ; Malik, Waqar ; Taheri, Shahrad. / The impact of a diabetes local enhanced service on quality outcome framework diabetes outcomes. In: PLoS One. 2013 ; Vol. 8, No. 12.
@article{d21f381796f94d1c8c992403353254c2,
title = "The impact of a diabetes local enhanced service on quality outcome framework diabetes outcomes",
abstract = "Background: The rising challenge of diabetes requires novel service delivery approaches. In the UK, Local Enhanced Services (LES) have been commissioned for diabetes. Health professionals from general practices (GPs) who signed up to LES were given additional training (and a monetary incentive) to improve management of patients with diabetes. All practices in the PCT were invited to the LES initiative, which ensured avoiding selection bias. The aim of the study was to examine the impact of LES in terms of diabetes Quality Outcome Framework (QOF) indicators: DM23(glycaemia), DM17(lipid) and DM12(blood pressure; BP). Methods: QOF diabetes indicators were examined using data from 76 general practices for 2009-2010 in a large primary care trust area in Birmingham, UK. Data were extracted from Quality Management Analysis System. The primary outcome was a difference in achievement of QOF indicators between LES and NLES practices. A secondary outcome was the difference between LES and non-LES practices for hospital first and follow-up appointments. Results: We did not find any difference for DM12(BP) and DM17(lipid) outcomes between LES and NLES practices. However, LES practices were more likely to achieve the DM23(glycaemia) outcome (estimated odds 1.459;95{\%} CI: 1.378-1.544; P=0.0001). The probability of achieving satisfactory level of DM23(glycaemia) increased by almost 10{\%} when GPs belonged to LES groups compared with GPs in NLES group. LES practices were less likely to refer patients to secondary care. Conclusion: Overall, LES practices performed better in the achievement of DM23(glycaemia) and also referred fewer patients to hospital, thereby meeting their objectives. This suggests that the LES approach is beneficial and needs to be further explored in order to ascertain whether the impact exerted was due to LES.",
author = "Sopna Choudhury and Shakir Hussain and Guiqing Yao and Jill Hill and Waqar Malik and Shahrad Taheri",
year = "2013",
month = "12",
day = "17",
doi = "10.1371/journal.pone.0083738",
language = "English",
volume = "8",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

TY - JOUR

T1 - The impact of a diabetes local enhanced service on quality outcome framework diabetes outcomes

AU - Choudhury, Sopna

AU - Hussain, Shakir

AU - Yao, Guiqing

AU - Hill, Jill

AU - Malik, Waqar

AU - Taheri, Shahrad

PY - 2013/12/17

Y1 - 2013/12/17

N2 - Background: The rising challenge of diabetes requires novel service delivery approaches. In the UK, Local Enhanced Services (LES) have been commissioned for diabetes. Health professionals from general practices (GPs) who signed up to LES were given additional training (and a monetary incentive) to improve management of patients with diabetes. All practices in the PCT were invited to the LES initiative, which ensured avoiding selection bias. The aim of the study was to examine the impact of LES in terms of diabetes Quality Outcome Framework (QOF) indicators: DM23(glycaemia), DM17(lipid) and DM12(blood pressure; BP). Methods: QOF diabetes indicators were examined using data from 76 general practices for 2009-2010 in a large primary care trust area in Birmingham, UK. Data were extracted from Quality Management Analysis System. The primary outcome was a difference in achievement of QOF indicators between LES and NLES practices. A secondary outcome was the difference between LES and non-LES practices for hospital first and follow-up appointments. Results: We did not find any difference for DM12(BP) and DM17(lipid) outcomes between LES and NLES practices. However, LES practices were more likely to achieve the DM23(glycaemia) outcome (estimated odds 1.459;95% CI: 1.378-1.544; P=0.0001). The probability of achieving satisfactory level of DM23(glycaemia) increased by almost 10% when GPs belonged to LES groups compared with GPs in NLES group. LES practices were less likely to refer patients to secondary care. Conclusion: Overall, LES practices performed better in the achievement of DM23(glycaemia) and also referred fewer patients to hospital, thereby meeting their objectives. This suggests that the LES approach is beneficial and needs to be further explored in order to ascertain whether the impact exerted was due to LES.

AB - Background: The rising challenge of diabetes requires novel service delivery approaches. In the UK, Local Enhanced Services (LES) have been commissioned for diabetes. Health professionals from general practices (GPs) who signed up to LES were given additional training (and a monetary incentive) to improve management of patients with diabetes. All practices in the PCT were invited to the LES initiative, which ensured avoiding selection bias. The aim of the study was to examine the impact of LES in terms of diabetes Quality Outcome Framework (QOF) indicators: DM23(glycaemia), DM17(lipid) and DM12(blood pressure; BP). Methods: QOF diabetes indicators were examined using data from 76 general practices for 2009-2010 in a large primary care trust area in Birmingham, UK. Data were extracted from Quality Management Analysis System. The primary outcome was a difference in achievement of QOF indicators between LES and NLES practices. A secondary outcome was the difference between LES and non-LES practices for hospital first and follow-up appointments. Results: We did not find any difference for DM12(BP) and DM17(lipid) outcomes between LES and NLES practices. However, LES practices were more likely to achieve the DM23(glycaemia) outcome (estimated odds 1.459;95% CI: 1.378-1.544; P=0.0001). The probability of achieving satisfactory level of DM23(glycaemia) increased by almost 10% when GPs belonged to LES groups compared with GPs in NLES group. LES practices were less likely to refer patients to secondary care. Conclusion: Overall, LES practices performed better in the achievement of DM23(glycaemia) and also referred fewer patients to hospital, thereby meeting their objectives. This suggests that the LES approach is beneficial and needs to be further explored in order to ascertain whether the impact exerted was due to LES.

UR - http://www.scopus.com/inward/record.url?scp=84892907062&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892907062&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0083738

DO - 10.1371/journal.pone.0083738

M3 - Article

VL - 8

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

M1 - e83738

ER -