Managed care organization and the quality of diabetes care: The Translating Research into Action for Diabetes (TRIAD) study

Catherine Kim, David F. Williamson, Carol M. Mangione, Monika M. Safford, Joseph V. Selby, David Marrero, J. David Curb, Theodore J. Thompson, K. M Venkat Narayan, William H. Herman

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

OBJECTIVE - To examine the association between the organizational model and diabetes processes of care. RESEARCH DESIGN AND METHODS - We used data from the Translating Research into Action for Diabetes (TRIAD), a multicenter study of diabetes care in managed care, including 8,354 patients with diabetes. We identified five model types: for-profit group/network, for-profit independent practice association (IPA), nonprofit group/network, nonprofit IPA, and nonprofit group/staff. Process measures included retinal, renal, foot, lipid, and HbA1c testing; aspirin recommendations; influenza vaccination; and a sum of these seven processes of care over 1 year. Hierarchical regression models were constructed for each process measure and accounted for clustering at the health plan and provider group levels and adjusted for participant age, sex, race, ethnicity, diabetes treatment and duration, education, income, health status, and survey language. RESULTS - Participant membership in the model types ranged from 9% in nonprofit IPA models to 38% in nonprofit group/staff models. Over 75% of participants received most of the processes of care, regardless of model type. However, among for-profit plans, group/network models provided on average more processes of care than IPA models (5.5 vs. 4.7, P < 0.0001), and group/network models generally increased the probability of receiving a process by ≥10 percentage points. Among nonprofit plans, no effect of model type was found. CONCLUSIONS - Among for-profit plans, group/network models provided better diabetes processes of care than IPA models. Although reasons are speculative, this may be due to the clinical infrastructure available in group models that is not available in IPA models.

Original languageEnglish
Pages (from-to)1529-1534
Number of pages6
JournalDiabetes Care
Volume27
Issue number7
DOIs
StatePublished - Jul 2004

Fingerprint

Independent Practice Associations
Quality of Health Care
Managed Care Programs
Organizations
Research
Process Assessment (Health Care)
Organizational Models
Health Surveys
Human Influenza
Aspirin
Health Status
Multicenter Studies
Cluster Analysis
Foot
Vaccination
Research Design
Language
Kidney
Lipids
Education

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Managed care organization and the quality of diabetes care : The Translating Research into Action for Diabetes (TRIAD) study. / Kim, Catherine; Williamson, David F.; Mangione, Carol M.; Safford, Monika M.; Selby, Joseph V.; Marrero, David; Curb, J. David; Thompson, Theodore J.; Narayan, K. M Venkat; Herman, William H.

In: Diabetes Care, Vol. 27, No. 7, 07.2004, p. 1529-1534.

Research output: Contribution to journalArticle

Kim, C, Williamson, DF, Mangione, CM, Safford, MM, Selby, JV, Marrero, D, Curb, JD, Thompson, TJ, Narayan, KMV & Herman, WH 2004, 'Managed care organization and the quality of diabetes care: The Translating Research into Action for Diabetes (TRIAD) study', Diabetes Care, vol. 27, no. 7, pp. 1529-1534. https://doi.org/10.2337/diacare.27.7.1529
Kim, Catherine ; Williamson, David F. ; Mangione, Carol M. ; Safford, Monika M. ; Selby, Joseph V. ; Marrero, David ; Curb, J. David ; Thompson, Theodore J. ; Narayan, K. M Venkat ; Herman, William H. / Managed care organization and the quality of diabetes care : The Translating Research into Action for Diabetes (TRIAD) study. In: Diabetes Care. 2004 ; Vol. 27, No. 7. pp. 1529-1534.
@article{0af200e84db24834b9dcee5e4a421d41,
title = "Managed care organization and the quality of diabetes care: The Translating Research into Action for Diabetes (TRIAD) study",
abstract = "OBJECTIVE - To examine the association between the organizational model and diabetes processes of care. RESEARCH DESIGN AND METHODS - We used data from the Translating Research into Action for Diabetes (TRIAD), a multicenter study of diabetes care in managed care, including 8,354 patients with diabetes. We identified five model types: for-profit group/network, for-profit independent practice association (IPA), nonprofit group/network, nonprofit IPA, and nonprofit group/staff. Process measures included retinal, renal, foot, lipid, and HbA1c testing; aspirin recommendations; influenza vaccination; and a sum of these seven processes of care over 1 year. Hierarchical regression models were constructed for each process measure and accounted for clustering at the health plan and provider group levels and adjusted for participant age, sex, race, ethnicity, diabetes treatment and duration, education, income, health status, and survey language. RESULTS - Participant membership in the model types ranged from 9{\%} in nonprofit IPA models to 38{\%} in nonprofit group/staff models. Over 75{\%} of participants received most of the processes of care, regardless of model type. However, among for-profit plans, group/network models provided on average more processes of care than IPA models (5.5 vs. 4.7, P < 0.0001), and group/network models generally increased the probability of receiving a process by ≥10 percentage points. Among nonprofit plans, no effect of model type was found. CONCLUSIONS - Among for-profit plans, group/network models provided better diabetes processes of care than IPA models. Although reasons are speculative, this may be due to the clinical infrastructure available in group models that is not available in IPA models.",
author = "Catherine Kim and Williamson, {David F.} and Mangione, {Carol M.} and Safford, {Monika M.} and Selby, {Joseph V.} and David Marrero and Curb, {J. David} and Thompson, {Theodore J.} and Narayan, {K. M Venkat} and Herman, {William H.}",
year = "2004",
month = "7",
doi = "10.2337/diacare.27.7.1529",
language = "English",
volume = "27",
pages = "1529--1534",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "7",

}

TY - JOUR

T1 - Managed care organization and the quality of diabetes care

T2 - The Translating Research into Action for Diabetes (TRIAD) study

AU - Kim, Catherine

AU - Williamson, David F.

AU - Mangione, Carol M.

AU - Safford, Monika M.

AU - Selby, Joseph V.

AU - Marrero, David

AU - Curb, J. David

AU - Thompson, Theodore J.

AU - Narayan, K. M Venkat

AU - Herman, William H.

PY - 2004/7

Y1 - 2004/7

N2 - OBJECTIVE - To examine the association between the organizational model and diabetes processes of care. RESEARCH DESIGN AND METHODS - We used data from the Translating Research into Action for Diabetes (TRIAD), a multicenter study of diabetes care in managed care, including 8,354 patients with diabetes. We identified five model types: for-profit group/network, for-profit independent practice association (IPA), nonprofit group/network, nonprofit IPA, and nonprofit group/staff. Process measures included retinal, renal, foot, lipid, and HbA1c testing; aspirin recommendations; influenza vaccination; and a sum of these seven processes of care over 1 year. Hierarchical regression models were constructed for each process measure and accounted for clustering at the health plan and provider group levels and adjusted for participant age, sex, race, ethnicity, diabetes treatment and duration, education, income, health status, and survey language. RESULTS - Participant membership in the model types ranged from 9% in nonprofit IPA models to 38% in nonprofit group/staff models. Over 75% of participants received most of the processes of care, regardless of model type. However, among for-profit plans, group/network models provided on average more processes of care than IPA models (5.5 vs. 4.7, P < 0.0001), and group/network models generally increased the probability of receiving a process by ≥10 percentage points. Among nonprofit plans, no effect of model type was found. CONCLUSIONS - Among for-profit plans, group/network models provided better diabetes processes of care than IPA models. Although reasons are speculative, this may be due to the clinical infrastructure available in group models that is not available in IPA models.

AB - OBJECTIVE - To examine the association between the organizational model and diabetes processes of care. RESEARCH DESIGN AND METHODS - We used data from the Translating Research into Action for Diabetes (TRIAD), a multicenter study of diabetes care in managed care, including 8,354 patients with diabetes. We identified five model types: for-profit group/network, for-profit independent practice association (IPA), nonprofit group/network, nonprofit IPA, and nonprofit group/staff. Process measures included retinal, renal, foot, lipid, and HbA1c testing; aspirin recommendations; influenza vaccination; and a sum of these seven processes of care over 1 year. Hierarchical regression models were constructed for each process measure and accounted for clustering at the health plan and provider group levels and adjusted for participant age, sex, race, ethnicity, diabetes treatment and duration, education, income, health status, and survey language. RESULTS - Participant membership in the model types ranged from 9% in nonprofit IPA models to 38% in nonprofit group/staff models. Over 75% of participants received most of the processes of care, regardless of model type. However, among for-profit plans, group/network models provided on average more processes of care than IPA models (5.5 vs. 4.7, P < 0.0001), and group/network models generally increased the probability of receiving a process by ≥10 percentage points. Among nonprofit plans, no effect of model type was found. CONCLUSIONS - Among for-profit plans, group/network models provided better diabetes processes of care than IPA models. Although reasons are speculative, this may be due to the clinical infrastructure available in group models that is not available in IPA models.

UR - http://www.scopus.com/inward/record.url?scp=3042716848&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3042716848&partnerID=8YFLogxK

U2 - 10.2337/diacare.27.7.1529

DO - 10.2337/diacare.27.7.1529

M3 - Article

C2 - 15220223

AN - SCOPUS:3042716848

VL - 27

SP - 1529

EP - 1534

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 7

ER -