Jump to content

  • Set Your Location
  • Sign in or Enroll
Set Your LocationSet Your Location
  • Sign in or Enroll
    • Open I want to choose my medical group or hospital
    • Clear my location
Change Location
Sutter Health
  • Video Visits
  • Find Doctors
  • Find Locations
  • Treatments & Services
    • Video Visits
    • Find Doctors
    • Find Locations
    • Treatments & Services
    • COVID-19 Resources
    • Pay a Bill
    • Symptom Checker
    • Get Care Today
    • Health & Wellness
    • Classes & Events
    • Research & Clinical Trials
    • For Patients
    • About Sutter Health
    • Giving
    • Volunteering
    • Careers
    • News
    • For Medical Professionals
    • Other Business Services
Close Search
  • Home
  • Research
  • Cerebrovascular Disorders
Content

Primary care diabetes bundle management: 3-year outcomes for microvascular and macrovascular events.

Description

Bloom FJ Jr, Yan X, Stewart WF, Graf TR, Anderer T, Davis DE, Pierdon SB, Pitcavage J, Steele GD Jr., Am J Manag Care. 20(6):e175-82., 2014 Jun 01

Investigators

Xiaowei (Sherry) Yan, PhD, MS

Abstract

OBJECTIVES: To determine whether a system of care with an all-or-none bundled measure for primary-care management of diabetes mellitus reduced the risk of microvascular and macrovascular complications compared with usual care.

STUDY DESIGN: A parallel pre-post observational design was used. In 2006, a system of care for diabetes was implemented for some members of the Geisinger Health Plan. A total of 4095 primary-care patients were in the Diabetes System of Care group (DS) and compared with a propensity score-matched cohort of 4095 primary care patients not in the system of care (non-Diabetes System of Care [NDS]).METHODS: Cumulative hazard rate was measured over a 3-year period for retinopathy, amputation, stroke, and myocardial infarction (MI).

RESULTS: The adjusted hazard ratios (HRs) for MI (HR, 0.77; 95% CI, 0.65- 0.90), stroke (HR, 0.79; CI, 0.65-0.97), and retinopathy (HR, 0.81; CI, 0.68-0.97) were all significantly lower among DS patients. The adjusted HR for major amputations (HR, 1.32; CI, 0.45-3.85) did not differ between groups, but only 17 major amputations occurred during the follow-up period. The necessary number of patients to treat in order to prevent 1 event over 3 years was 82 for MI, 178 for stroke, and 151 for retinopathy.

CONCLUSIONS: A system of care with an all-or-none bundled measure used in primary care for patients with diabetes may reduce the risk of MI, stroke, and retinopathy over a 3-year period.

Pubmed Abstract

Pubmed AbstractOpens New Window

Associated Topics

  • Cerebrovascular Disorders
  • Diabetes Type 2
  • Health Services

Related Publications

The relative efficacy and safety of clopidogrel in women and men a sex-specific collaborative meta-analysis.

Berger JS, Bhatt DL, Cannon CP, Chen Z, Jiang L, Jones JB, Mehta SR, Sabatine MS, Steinhubl SR, Topol EJ, Berger PB.
J Am Coll Cardiol. 54(21):1935-45. doi: 10.1016/j.jacc.2009.05.074.
2009 Nov 17

Intracardiac papillary fibroelastoma: an occult cause of embolic neurologic deficit.

McFadden PM, Lacy JR.
Ann Thorac Surg. 43(6):667-9.
1987 Jun 01

Geographic variations in cardiovascular disease mortality among Asian American subgroups, 2003-2011.

Pu J, Hastings KG, Boothroyd D, Jose PO, Chung S, Shah JB, Cullen MR, Palaniappan LP, Rehkopf DH.
J Am Heart Assoc. 6(7). pii: e005597. doi: 10.1161/JAHA.117.005597.
2017 Jul 12

Perceived appropriateness of shared decision-making in the emergency department: a survey study.

Probst MA, Kanzaria HK, Frosch DL, Hess EP, Winkel G, Ngai KM, Richardson LD.
Acad Emerg Med. 23(4):375-81. doi: 10.1111/acem.12904. Epub 2016 Mar 22.
2016 Apr 01

Dabigatran versus warfarin for atrial fibrillation in real-world clinical practice: a systematic review and meta-analysis.

Romanelli RJ, Nolting L, Dolginsky M, Kym E, Orrico KB.
Circ Cardiovasc Qual Outcomes. pii: CIRCOUTCOMES.115.002369. [Epub ahead of print]
2016 Jan 26
The Sutter Health Network of Care
Expertise to fit your needs
Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

  • Contact Us
  • Find Doctors
  • Find Locations
  • Request Medical Records
  • Make a Gift
Sign in to My Health Online

Billing and Insurance

  • Pay a Bill
  • Accepted Health Plans
  • Estimate Costs
  • Medicare Advantage

About Sutter

  • About Our Network
  • Community Benefit
  • Annual Report
  • News

Our Team

  • For Employees
  • For Medical Professionals
  • For Vendors
  • For Volunteers

Careers

  • Jobs at Sutter
  • Physician Jobs
  • Graduate Medical Education

Copyright © 2023 Sutter Health. All rights reserved. Sutter Health is a registered trademark of Sutter Health ®, Reg. U.S. Patent & Trademark office.

  • ADA Accessibility
  • Privacy
  • Do Not Sell My Personal Information
  • LinkedIn Opens new window
  • YouTube Opens new window
  • Facebook Opens new window
  • Twitter Opens new window
  • Instagram Opens new window
  • Glassdoor Opens new window

Cookie Policy

We use cookies to give you the best possible user experience. By continuing to use the site, you agree to the use of cookies. Privacy Policy Cookie Preferences

Privacy Policy Cookie Preferences