Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

Green, Michael E; Hogg, William; Savage, Colleen; Johnston, Sharon; Russell, Grant; Jaakkimainen, R Liisa; Glazier, Richard H; Barnsley, Janet; Birtwhistle, Richard

doi:10.1186/1472-6963-12-214

BMC Health Services Research

Table 7 Comparison of chronic disease management (CDM) between chart abstraction and patient survey

From: Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

Chart Abstraction		Patient Survey
Was any advice/info		Yes	No	Total	Kappa	95% CI
/resources/websites	Yes	280	26	306	.39	(0.346, .434)
/pamphlets given	No	359	580	939		% agreement
regarding disease?	Total	639	606	1245		=69%
Patient ever had a heart		Yes	No	Total	Kappa	95% CI
attack?	Yes	14	3	17	0.531	(.355, .708)
	No	18	221	239		% agreement
	Total	32	224	256		=92%
Hospitalized for		Yes	No	Total	Kappa	95% CI
Chronic disease	Yes	6	6	12	0.385	(.149, .621)
	No	11	275	286		% agreement
	Total	17	281	298		=94%
Wt/Ht/Wc ≤12mo?		Yes	No	Total	Yes	No
	Yes	188	33	221	0.166	(.500, .272)
	No	82	35	117		% agreement
	Total	270	68	338		=66%
Fasting Blood		Yes	No	Total	Kappa	95% CI
Sugar^a	Yes	223	20	243	0.122	(0, .244)
	No	54	12	66		% agreement
	Total	277	32	309		=76%
Lipid profile done^b		Yes	No	Total	Kappa	95% CI
	Yes	220	6	226	0.312	(.122, .511)
	No	22	8	30		% agreement
	Total	242	14	256		=89%
BP controlled^c (<140/90) ^d		Yes	No	Total	Kappa	95% CI
	Yes	109	10	119	0.218	(.086, .35)
	No	50	19	69		% agreement
	Total	159	29	188		=68%
EKG^c		Yes	No	Total	Kappa	95% CI
	Yes	31	11	42	0.298	(.168, .428)
	No	49	93	142		% agreement
	Total	80	104	184		=67%
Renal function ^e		Yes	No	Total	Kappa	95% CI
(microalbumin)	Yes	54	4	58	0.023	(-.151, .204)
	No	21	2	23		% agreement
	Total	75	6	81		=69%
Lipids controlled		Yes	No	Total	Kappa	95% CI
(LDL < 4.5 &	Yes	101	7	108	0.337	(.087, .587)
total chol :HDL < 6.0)^f	No	10	6	16		% agreement
	Total	111	13	124		=86%
AIC ≤2 yrs ^e		Yes	No	Total	Kappa	95% CI
	Yes	41	5	46	-.117	(-.189,.045)
	No	6	0	6		% agreement
	Total	47	5	52		=79%
Foot exam ^e		Yes	No	Total	Kappa	95% CI
	Yes	51	3	54	0.327	(.103, .551)
	No	16	8	24		% agreement
	Total	66	11	78		=76%
Eye exam ^e		Yes	No	Total	Kappa	95% CI
	Yes	53	4	57	0.15	(-.074, .374)
	No	17	4	21		% agreement
	Total	70	8	78		=73%
ASA		Yes	No	Total	Kappa	95% CI
	Yes	92	5	97	0.572	(.472, .672)
	No	45	85	130		% agreement
	Total	137	90	227		=78%
ACE		Yes	No	Total	Kappa	95% CI
	Yes	93	14	107	0.722	(.622, .822)
	No	13	78	91		% agreement
	Total	106	92	198		=86%
ARB		Yes	No	Total	Kappa	95% CI
	Yes	37	13	50	0.703	(.583, .823)
	No	8	128	136		% agreement
	Total	45	141	186		=89%
Beta blocker		Yes	No	Total	Kappa	95% CI
	Yes	58	10	68	0.675	(.568, .783)
	No	20	110	130		% agreement
	Total	78	120	198		=85%
Calcium channel		Yes	No	Total	Kappa	95% CI
blocker^g	Yes	36	11	47	0.68	(.552, .808)
	No	10	101	111		% agreement
	Total	46	112	158		=87%
Diuretic^g		Yes	No	Total	Kappa	95% CI
	Yes	86	11	97	0.701	(.689, .813)
	No	13	56	69		% agreement
	Total	99	67	166		=86%
Statin		Yes	No	Total	Kappa	95% CI
	Yes	113	95	208	0.005	(-.045, .055)
	No	3	3	6		% agreement
	Total	116	98	214		=54%

Notes: ^a Survey asked if ever; CA reported < = 2 y. ^bSurvey < 12 mo; CA < = 2 y. ^cSpecific to HTN only. ^d 2 high risk patients with BP over low risk cut offs but under high risk cut offs, correctly identified themselves as not under control. ^e Specific to DM only. ^f2 high risk patients with lipids over low risk cut offs but under high risk cut offs, correctly identified themselves as not under control. ^gAsked under HTN section in survey only.

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ISSN: 1472-6963

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