Rehman H, et al. – Researchers deliberated that there is suboptimal glycemic and blood pressure control with significant facility–level variation in patients with diabetes. They exhibited evidence that facility–level rates for blood pressure control and glycemic control remain low with significant facility–level variation. Moreover, much of this is explained by patient and facility–level variables while 16%, 25%, and 15% variation in glycemic, blood pressure, and combined glycemic and BP control remains unexplained.

Methods

• They distinguished patients with diabetes receiving care in 130 facilities in the Veterans Affairs Health Care System.
• They evaluated facility–level rates of glycemic (hemoglobin [Hb]A1c

Results

• It was noted that 50.2% participants had an HbA1c
• The results indicated that median facility–level rates were 50.3% (interquartile range [IQR], 47.9%–52.4%) for glycemic control, 78.4% (IQR, 75.2%–80.0%) for BP control, and 39.9% (IQR, 38.14%–42.34%) for combined glycemic and BP control.
• The evidence showed that unadjusted MRR for glycemic control was 1.61 (95% confidence interval [CI]: 1.51–1.70) which decreased to 1.16 (95% CI: 1.14–1.19) after adjusting for patient and facility–level variables, indicating a 16% variation in glycemic control between 2 identical patients receiving care at 2 random facilities.
• The obtained data indicates that unadjusted MRR for BP control was 1.49 (95% CI: 1.41–1.56), which decreased to 1.25 (95% CI: 1.21–1.28), whereas unadjusted MRR for combined glycemic and BP control was 1.59 (95% CI: 1.50–1.68), which decreased to 1.15 (95% CI: 1.13–1.17) after adjustment.