Does a Large-Scale Organizational Transformation Toward Patient-Centered Access Change the Utilization and Costs of Care for Patients with Diabetes?

Details

• Personal Author:
  Anderson ML ; Grembowski D ; Martin DP ; Ralston JD ; Reid R
• Description:
  The authors examined whether Group Health's Access Initiative changed the utilization and costs of care among enrollees with diabetes. Using a single (one-group) interrupted time series design, repeated-measures generalized estimating equation models were used to estimate changes in utilization and costs during the Initiative rollout (2002-2003) and to compare the slopes (annual rates of change) for utilization and costs during the Pre-Initiative period (1998-2002) to the slopes during Full-Implementation (2003-2006) among 9,871 members continuously enrolled from 1997 to 2006 with type 1 or 2 diabetes. Total costs increased in Full-Implementation, but the annual change in total costs did not change. Primary care visits declined, but primary care contacts grew, largely from the Initiative's introduction of secure messaging. Specialty visits did not change; however, the Initiative may have increased emergency visits. To reduce emergency visits, future access initiatives should include proactive and comprehensive outpatient care for patients with diabetes. [Description provided by NIOSH]
• Subjects:
  Blood Hematologic Diseases Occupational Health Safety
• Keywords:
  Access Advanced Access Author Keywords: Diabetes Blood Sugar Disorders Cost Costs Direct Access Electronic Medical Record Gate Keeping Health Care Medical Treatment Patient-centered Care Secure Messaging Utilization

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• ISSN:
  1077-5587
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 10 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  69
• Issue:
  5
• NIOSHTIC Number:
  nn:20056509
• Citation:
  Med Care Res Rev 2012 Oct; 69(5):519-539
• Contact Point Address:
  David Grembowski, Department of Health Services, School of Public Health, University of Washington, 1959 NE Pacific Street, Box 357660, Seattle, WA 98195-7475, USA
• Email:
  grem@u.washington.edu
• Federal Fiscal Year:
  2013
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Medical Care Research and Review
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7dc782e9b3693878a2c302a89799cdd8972d448a4f5213ba3ecd858f6cc137f5a9e9ceb7070848b8ed19aceac4806924110bc4a689be84a17f5da7f3676d6ebc
• Download URL:
  https://stacks.cdc.gov/view/cdc/214107/cdc_214107_DS1.pdf
• File Type:
  [PDF - 700.60 KB ]