• Open Access

Associations between technical quality of diabetes care and patient experience

Authors

  • Onyebuchi A. Arah MD PhD,

    1. Adjunct Faculty, Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
    2. Associate Professor, Department of Epidemiology, University of California, Los Angeles (UCLA), School of Public Health, Los Angeles, California, United States;
    3. Faculty Associate, Center for Health Policy Research, UCLA, Los Angeles, California, United States;
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  • Bastiaan Roset MSc,

    1. Research fellow, Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands;
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  • Diana M. J. Delnoij PhD,

    1. Director, Center for Consumer Experience in Health Care, Utrecht, the Netherlands.
    2. Scientific Centre for Transformation in Care and Welfare (Tranzo), University of Tilburg, Tilburg, the Netherlands;
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  • Niek S. Klazinga MD PhD,

    1. Professor, Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
    2. Lead, Healthcare Quality Indicators Project, Organisation for Economic Cooperation and Development (OECD), Paris, France
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  • Karien Stronks PhD

    1. Professor and Chair, Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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Onyebuchi A. Arah, MD, PhD
Department of Epidemiology
University of California,
Los Angeles (UCLA)
School of Public Health
Box 951772
Los Angeles
CA 90095 1772
USA
E-mail: arah@ucla.edu

Abstract

Aims  It has long been held that high-quality care has both technical and interpersonal aspects. The nature and strength of any association between both aspects remain poorly explored. This study investigated the associations between diabetes patients’ reports of receiving recommended care (as measures of technical quality) and their experience and ratings (as measures of interpersonal care).

Methods  Using data from a cross section of 3096 patients with diabetes nested within 24 diabetes-care-networks, we conducted multilevel regression analysis of the relationships between nine indicators of receiving care recommended in practice guidelines and: six scales of patient experience and global ratings of general practitioner, nurses, and overall diabetes care.

Results  On average, reporting having received recommended care was associated with reporting better patient experience and ratings. The extent and frequencies of these associations varied across the different care processes. Receiving foot examination, physical activity advice, smoking status check, eye examination, and HbA1c testing, but not nutritional advice, urine, cholesterol or blood pressure checks, were statistically associated with better patient experience and global ratings. Those who received HbA1c testing rated their overall care 1.002 points higher (95% confidence interval: 0.726–1.278) on a scale of 0–10 than those who did not.

Conclusions  Higher self-reported technical quality of care in diabetes appears to be frequently but not always associated with better experiences and ratings. It is possible that the former leads to the latter and/or that both share a common cause within providers. Both care aspects do not seem interchangeable during performance assessment.

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