Chronic Care Clinics for Diabetes in Primary Care A system-wide randomized trial

摘要: OBJECTIVE —To evaluate the impact of primary care group visits (chronic clinics) on process and outcome for diabetic patients. RESEARCH DESIGN AND METHODS —We evaluated intervention in practices randomized to control groups a large-staff model health maintenance organization (HMO). Patients included patients ≥30 years age each participating practice, selected at random from an automated diabetes registry. Primary were within clinics either chronic clinic (intervention) or usual (control) group. The conducted periodic one-half day ∼8 their respective doctor’s practice. Chronic consisted standardized assessments; with physician, nurse, clinical pharmacist; education/peer support meeting. We collected self-report questionnaires data administrative systems. mailed, telephoned interviews nonrespondents, baseline 12 24 months; we queried received, satisfaction care, status patient. Serum cholesterol HbA1c levels use cost was HMO systems. RESULTS —In intention-to-treat analysis months, had received significantly more recommended preventive procedures helpful patient education. Of five indicators examined, two (SF-36 general bed disability days) better Compared patients, slightly visits, but fewer specialty emergency room visits. Among participants, found consistently positive associations between number attended outcomes, including levels. CONCLUSIONS —Periodic sessions organized meet complex needs improved associated outcomes.