Impact of a chronic care coordinator intervention on diabetes quality of care in a community health center

Abstract

Purpose: To evaluate the impact of a clinic-based chronic care coordinator (CCC) intervention on quality of diabetes care, health outcomes and health service utilization within six community health centers serving predominantly low-income Hispanic and non-Hispanic white patients.

Methods: We used a retrospective cohort study design with a 12-month pre- and 12-month postintervention analysis to evaluate the effect of the CCC intervention and examined: (1) the frequency of testing for glycated hemoglobin (HbAIC), cholesterol LDL level, and microalbumin screen and frequency of retinal and foot exam; (2) outcomes for HbAIC levels, lipid, and blood pressure control; and (3) health care service utilization. Patients with diabetes who received the CCC intervention (n = 329) were compared to a propensity score adjusted control group who are not exposed to the CCC intervention (n = 329). All of the data came from Electronic Medical Record. Four separate sets of analyses were conducted to demonstrate the effect of propensity score matching on results.

Results: The CCC intervention led to improvements in process measures, including more laboratory checks for HbAIC levels, microalbuminuria screens, retinal and foot exams and also increased primary care visits. However, the intervention did not improve metabolic control.

Conclusions: CCC interventions offer promise in improving process measures within community health centers but need to be modified to improve metabolic control.

Keywords: Diabetes; Hispanic; chronic care coordinators.