Guideline Adherence and Health Outcomes in Medicare Fee for Service Patients with Diabetes

Principal Investigator: Maureen Smith

There is increasing recognition that treatment recommendations considered appropriate for younger individuals with diabetes may confer greater short-term risks and fewer long-term benefits for older patients and those with co-morbid conditions, yet little empirical evidence exists to guide providers in tailoring treatment for these patients. In this project, we aim to define the outcomes of tight disease control for older adults and those with co-morbid congestive heart failure and chronic kidney disease. Measures of disease control (hemoglobin A1c, LDL cholesterol, and blood pressure values) will be obtained from electronic health records for patients receiving diabetes care at the UW Medical Foundation and linked to claims data from Medicare and several private insurers to determine if tight disease control is related to increased risk of emergency room visits, hospitalization and/or death for patients with these comorbidities. The results of this investigation will help provide an evidence base for tailoring diabetes treatment guidelines, developing quality metrics that may be used in pay-for-performance initiatives and other quality improvement efforts, and ultimately improving medical care for older patients with diabetes and/or those with other chronic health conditions

Funded by AHRQ