Diabetes ratings show room for improvement

By Dan Linehan
The Free Press

MANKATO July 05, 2008 12:58 am

— One of Mankato Clinic’s sites is tops in the region when it comes to diabetes care, but another is the lowest, exposing the challenges health care companies face in developing standards, according to a report from a Minneapolis nonprofit.
MN Community Measurement evaluated 345 clinics and hospitals statewide for the care they provide to diabetes patients as well as those with stroke or heart attack concerns.
Immanuel St. Joseph’s Hospital was not evaluated.
The report measured “optimal” care in each category based on a series of criteria. For diabetes patients, they are: blood sugar, blood pressure, cholesterol, daily aspirin use and smoking, said Mark Matthias, chief medical officer at the clinic.
The heart attack and stroke evaluation uses the same criteria, minus blood sugar.
Only patients whose medical data fit healthy parameters in all five categories were rated as having “optimal care.”
Past studies have shown that diabetes patients who fall into those healthy categories are less likely to have complications.
In the clinic’s North Mankato branch, 34 percent of diabetes patients had optimal care, the highest number of the 15 clinics in the region. The Lake Crystal clinic had the lowest rating in the region, 9 percent.
Statewide ratings varied from 0 percent to 48 percent.
For heart attack and stroke care, the ratings varied from 43 percent in the North Mankato branch and the Winona Clinic to 27 percent at the Allina Medical Clinic in Faribault.
Matthias said the key to improving diabetes care is to be relentless in following up with patients.
That can take many forms, from reminding them to take aspirin to regular blood tests to smoking-cessation help.
As for the difference between sites, Matthias said it’s partly due to different client groups as well as different practices. But the clinic is looking to change that, he said.
One method is computer alerts that will, say, notify doctors if a diabetes patient hasn’t had a checkup in six months. The clinic plans to implement its electronic health records system in September.
Jim Chase, executive director of MN Community Measurement, said facilities with such electronics systems consistently scored higher.
Diabetes education is another factor.
If those with the disease know their blood sugar level is more than an abstraction, they might be more willing to take steps to lower it, Matthias said.
Average scores have been rising since the evaluation begin five years ago, from near zero to 17 percent for diabetes care, Chase said. He credits the new approaches health care companies are taking in working with patients.

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