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Self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care
Studies have provided promising outcomes of the pay-for-performance (P4P) program or with good continuity of care levels in diabetes control. We investigate the different exposures in continuity of care (COC) with their providers and those who participate in the P4P program and its effects on the ri...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284740/ https://www.ncbi.nlm.nih.gov/pubmed/34260563 http://dx.doi.org/10.1097/MD.0000000000026644 |
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author | Liao, Kuomeng Lin, Kuan-Chia Chiou, Shang-Jyh |
author_facet | Liao, Kuomeng Lin, Kuan-Chia Chiou, Shang-Jyh |
author_sort | Liao, Kuomeng |
collection | PubMed |
description | Studies have provided promising outcomes of the pay-for-performance (P4P) program or with good continuity of care levels in diabetes control. We investigate the different exposures in continuity of care (COC) with their providers and those who participate in the P4P program and its effects on the risk of diabetes diabetic nephropathy in the future. We obtained COC and P4P information from the annual database, to which we applied a hierarchical linear modeling (HLM) in 3 levels adjusted to account for other covariates as well as the effects of hospital clustering and accumulating time. Newly diagnosed type 2 diabetes in 2003 At the individual level, those with a higher Diabetes Complications Severity Index (DCSI) score have a higher likelihood of diabetic nephropathy than those with a lower DCSI (OR, 1.46), whereas contrasting results were obtained for the Charlson Comorbidity Index (CCI) (odds ratio[OR], 0.88). Patients who visited family physicians, endocrinologists, and gastroenterologists showed a lower likelihood of diabetic nephropathy (OR, 0.664, 0.683, and 0.641, respectively), whereas those who continued to visit neurologists showed an increased risk of diabetic nephropathy by 4 folds. At the hospital level, patients with diabetes visiting primary care clinics had a lower risk of diabetic nephropathy with an OR of 0.584 than those visiting hospitals of other higher levels. Regarding the repeat time level, the patients who had a higher COC score and participated in the P4P program had a reduced diabetic nephropathy risk with an OR of 0.339 and 0.775, respectively. Diabetes control necessitates long-term care involving the patients’ healthcare providers for the management of their conditions to reduce the risk of diabetic nephropathy. Indeed, most contributing factors are related to patients, but we cannot eliminate the optimal outcomes related to good relationships with healthcare providers and participation in the P4P program. |
format | Online Article Text |
id | pubmed-8284740 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-82847402021-07-19 Self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care Liao, Kuomeng Lin, Kuan-Chia Chiou, Shang-Jyh Medicine (Baltimore) 6600 Studies have provided promising outcomes of the pay-for-performance (P4P) program or with good continuity of care levels in diabetes control. We investigate the different exposures in continuity of care (COC) with their providers and those who participate in the P4P program and its effects on the risk of diabetes diabetic nephropathy in the future. We obtained COC and P4P information from the annual database, to which we applied a hierarchical linear modeling (HLM) in 3 levels adjusted to account for other covariates as well as the effects of hospital clustering and accumulating time. Newly diagnosed type 2 diabetes in 2003 At the individual level, those with a higher Diabetes Complications Severity Index (DCSI) score have a higher likelihood of diabetic nephropathy than those with a lower DCSI (OR, 1.46), whereas contrasting results were obtained for the Charlson Comorbidity Index (CCI) (odds ratio[OR], 0.88). Patients who visited family physicians, endocrinologists, and gastroenterologists showed a lower likelihood of diabetic nephropathy (OR, 0.664, 0.683, and 0.641, respectively), whereas those who continued to visit neurologists showed an increased risk of diabetic nephropathy by 4 folds. At the hospital level, patients with diabetes visiting primary care clinics had a lower risk of diabetic nephropathy with an OR of 0.584 than those visiting hospitals of other higher levels. Regarding the repeat time level, the patients who had a higher COC score and participated in the P4P program had a reduced diabetic nephropathy risk with an OR of 0.339 and 0.775, respectively. Diabetes control necessitates long-term care involving the patients’ healthcare providers for the management of their conditions to reduce the risk of diabetic nephropathy. Indeed, most contributing factors are related to patients, but we cannot eliminate the optimal outcomes related to good relationships with healthcare providers and participation in the P4P program. Lippincott Williams & Wilkins 2021-07-16 /pmc/articles/PMC8284740/ /pubmed/34260563 http://dx.doi.org/10.1097/MD.0000000000026644 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | 6600 Liao, Kuomeng Lin, Kuan-Chia Chiou, Shang-Jyh Self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care |
title | Self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care |
title_full | Self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care |
title_fullStr | Self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care |
title_full_unstemmed | Self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care |
title_short | Self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care |
title_sort | self-efficacy remains a vital factor in reducing the risk of dialysis in type 2 diabetes care |
topic | 6600 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284740/ https://www.ncbi.nlm.nih.gov/pubmed/34260563 http://dx.doi.org/10.1097/MD.0000000000026644 |
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