Rural Health Research Gateway

Rural Quality Improvement Focus on Diabetes

Funder: Office of Rural Health Policy (ORHP)
Research center: Rural Policy Research Institute (RUPRI) Center for Rural Health Policy Analysis
Phone: 402.559.5260
Lead researcher: J. Patrick Hart, PhD , 402.599.8964, jpathart@unmc.edu
Project completed:April 2005
Topics: Chronic diseases and conditions
Quality

This project examined the policy implications of current approaches, characteristics, and effectiveness of diabetes care management and quality improvement programs in rural areas. Diabetes is a well-understood disease for which there has been a reasonably large amount of program development in rural areas involving care management, self-management, and prevention, or combinations of these elements. Diabetes programs represent, therefore, a sound starting point for understanding the rural context, process, structure, barriers, and operational and performance results of chronic disease management and quality improvement programming in rural areas.

This project focused specifically on diabetes care management and quality improvement programming in rural areas to better understand the adaptability and policy implications of using chronic care coordination and other models in a rural environment. The following hypotheses will be researched:

  • Early adoption and success are more likely when there is active leadership, existing collaborative relationships such as alliances and networks, strong links to community-based resources needed for care management, active participation of the Quality Improvement Organization, and support from state professional associations.
  • The greater the distance that diabetes care programs are from urban counties the less likely the use of certified diabetes education and the less likely the program to be sustained.

Publications

  • Chronic Disease Management Systems (Registries) in Rural Health Care
    Author(s): Anne Skinner, Roslyn Fraser-Maginn, Keith J. Mueller
    Report Number: Rural Policy Brief Vol. 11, Number 1 (PB2006-1 )
    Date: 05 / 2006
    A Chronic Disease Management System (CDMS), or registry, is a tool that helps providers efficiently collect and analyze patient information to promote quality care for the rural population. The focus of this study was on the use of CDMSs in the management of diabetes, a disease prevalent in rural populations. Findings show that CDMSs are readily available to rural clinics and are being implemented and maintained by clinic staff with minimal expenditures for technology.
  • Elements of Successful Rural Diabetes Management Programs
    Author(s): Roslyn Fraser, Anne M. Skinner, Keith J. Mueller
    Report Number: P2006-2
    Date: 07 / 2006
    Reports findings from a study about local innovations implemented by rural chronic disease management programs. Using diabetes as a proxy for all chronic diseases, the authors explored how local innovations overcame challenges of the rural setting, such as low income, cultural differences, and long travel distances, to provide effective and efficient disease management.