Racial and Ethnic Differences in Clinical Outcome Trajectories for Care Managed Patients
Bibliographic Data
| ID | 9101973 |
|---|---|
| Authors | Ana R Quiñones, Ana Quinones (0000-0001-6554-7734, Portland VA Medical Center, corresponding author), Katrina Ramsey (0000-0002-3958-0087, Oregon Health & Science University, corresponding author), Jason T Newsom (0000-0001-8353-7468, Institute on Aging), David A Dorr (0000-0003-2318-7261, Oregon Health & Science University) |
| Year | 2014 |
| Volume | 52 |
| Issue | 11 |
| Pages | 998-1005 |
| Publication date | 2014-11-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000249 |
| PMID | 25304019 |
| OpenAlex | W2074336247 |
| Language | EN |
| Citations received | 1 |
| References cited | 25 |
BACKGROUND: Care management has demonstrated improvements in quality of care for patients with complex care needs. The extent to which these interventions benefit race/ethnic minority populations is unclear. OBJECTIVES: To characterize race/ethnic differences in the longitudinal control of clinical outcomes for patients with complex care needs enrolled in Care Management Plus, a health information technology-enabled care coordination intervention. RESEARCH DESIGN: Multilevel models of repeated observations from clinical encounters before and after program enrollment for 6 Oregon and California primary care clinics. SUBJECTS: A total of 18,675 clinic patients were examined. We estimated multilevel models for 1481 and 5320 care-managed individuals with repeated hemoglobin A1c and blood pressure measurements, respectively. MEASURES: Primary outcomes were changes over time for 2 clinical markers of health status for complex care patients: (1) hemoglobin A1c for patients with diabetes; and (2) mid-blood pressure (BP) (average systolic and diastolic blood pressure). RESULTS: We found significant reductions in A1c for patients with previously uncontrolled A1c (preperiod slope, b=1.03 [0.83, 1.24]; postperiod slope, b=-0.63 [-0.91, -0.35]). For mid-BP we found increasing unconditional preperiod trajectories (b=3.52 [2.39, 4.64]) and decreasing postperiod trajectories (b=-5.21 [-5.70, -4.72]). We also found the trajectories of A1c and mid-BP were not statistically different for black, Latino, and white patients. CONCLUSIONS: These analyses demonstrate some promising results for intermediate clinical outcomes for underrepresented patients with complex chronic care needs. It remains to be seen whether these health care system delivery redesigns yield long-term benefits for patients, such as improvements in function and quality of life
Blood pressure · Diabetes mellitus · Ethnic group · Family medicine · Health care · Physical therapy · Psychological intervention · Chronic Disease Management Strategies · Demography · Diabetes Management and Education · Internal Medicine · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology
Multiple Chronic Conditions
The Measurement of Multiple Chronic Diseases--A Systematic Review on Existing Multimorbidity Indices
Social Sources Of Racial Disparities In Health
Trends in Prevalence, Awareness, Treatment, and Control of Hypertension in the United States, 1988-2000
Broadening the FocusThe Need to Address the Social Determinants of Health
Twelve Frequently Asked Questions About Growth Curve Modeling
Multilevel Analysis in Public Health Research
Contribution of Primary Care to Health Systems and Health
How Does the Trajectory of Multimorbidity Vary Across Black, White, and Mexican Americans in Middle and Old Age
The disablement process
| Unique citing works | 1 |
|---|---|
| Citations per year | 0,2 |
| Citation span | 2021 - 2021 (1) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 1 |