Jackson County Free Health Clinic Diabetes Data July 2006 to June 2007
| Benchmark Data | |||
| June, 2006 | June, 2007 | ||
| Number of Patients | 86 | 92 | |
| A1C | |||
| Well controlled with A1c less than 7.0 |
37%1
|
43.0% | 55.4% |
| --(represents normal average blood sugars) | |||
| Poorly controlled with A1c greater than 9.1 |
29.7%2
|
16.3% | 15.2% |
| --(patients with highest risk of complications) | |||
| LDL ("bad" cholesterol) | |||
| Well controlled at less than 100 |
43.8%2
|
51.2% | 46.7% |
| Blood Pressure at or below goal 135/85 |
36%1
|
70.1% | ***52.2% |
| ***Lowered goal to 130/80 in 2007 | |||
| Microalbumin (urine protein) | |||
| Documented on chart within the year |
55.1%2
|
98.8% | 95.6% |
| Kidney disease treated with ACE | 100% | 100% | |
| Aspirin Compliance |
20%1
|
97.7% | 97.8% |
| Pneumonia vaccination |
21%3
|
88.5% | 96.7% |
| Flu vaccine |
40%3
|
81.4% | |
| Yearly Eye Exam |
54.8%2
|
79.1% | 75.0% |
| Documented Foot Exam | 51.1% | 94.6% | |
JCFHC data is obtained by chart review and computerized medical record review.
Patients are included if they have been seen within the preceding 9 months and
have been under care for at least 3 months.
There will be fluctuation in the number of patients due to some transience in
the population and movement on and off of Medicaid/Medicare.
1HEDIS (Health Plan Employer Data and Information Set) reports data on insured
patients for NCQA (National Committee for Quality Assurance)
2NHANES (National Health and Nutrition Examination Survey) conducted by the Centers
for Disease Control
3CDC (Centers for Disease Control) http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4842a3.htm
1. A1c measures the average blood sugar over 8-12 week period.
When patients have sugars in the normal range for most of the time, the A1c
will be less than 7.0%. This is by far the hardest outcome to achieve. The other
end of the spectrum includes patients who have very poorly controlled sugars
as indicated by those with A1c> 9.0%. Impact on complication prevention is
greatest in this group of patients. Many patients will not be able to get to
the goal of 7.0 but if they are able to improve their average sugars, they will
reduce their incidence of complications. We look at improvement or decline in
control as well as the absolute A1c.
2. Microalbumin is a marker for early kidney injury. If patients
are identified early and can get started on a special blood pressure medication
called ACE or ARB, they will not progress to kidney failure.
3. The number one cause of death in diabetes is heart disease.
Daily aspirin therapy, blood pressure control and aggressive
treatment of
high LDL cholesterol markedly reduce the risk of death.
4. Vaccination against influenza and pneumonia
reduce risk of hospitalization and of invasive infections. Diabetics have 3
times the rate of death from pneumonia.