A primary health-care system approach to improving quality of care and outcomes in people with diabetes: The University of Pittsburgh medical center experience

Abstract

Although substantial evidence exists demonstrating the efficacy of interventions for controlling risk factors for diabetes complications, dissemination into community practice is not widespread; for example, in the USA, only 18 % of people with diabetes are achieving goals for HbA1c, blood pressure, and LDL cholesterol. In order to address quality of care and outcomes in people with diabetes, the University of Pittsburgh Medical Center (UPMC) began adopting the elements of the Chronic Care Model using risk stratification, provider incentives, integration of care managers, travelling diabetes educators, population management, and collaboration with a single health insurer. This integrated model of care, tested in several initiatives, resulted in improved patient and provider outcomes. Over the 15-year period covered by this chapter, UPMC implemented innovative approaches that continue to respond to the needs of the rapidly growing population of people with diabetes in a dynamic health-care environment.