Minnesota clinics vary in quality of diabetes care, report says

  • Article by: MAURA LERNER , Star Tribune
  • Updated: June 30, 2008 - 9:40 PM

But critics say the scorecard ignores differences in patients' health and access to resources.

A new "health report card" has found that diabetics are much more likely to get their disease under control at some Minnesota clinics than others.

The report, by a group called MN Community Measurement, rated more than 300 clinics on their use of widely accepted best practices to treat diabetes and vascular diseases.

It found that on average only 17 percent of diabetics received "optimal" care in 2007, but the success rates ranged from 0 percent to 48 percent at different clinics.

Some of the highest ratings went to Fairview and Allina clinics, while some of the lowest were at clinics run by University of Minnesota physicians and those managed last year by Aspen Medical Group, which has since merged with Allina.

"The data show that where you go for health care matters just as much as what you eat and whether you exercise," said Jim Chase, executive director of MN Community Measurement, a nonprofit group.

Chase noted that some clinics have shown dramatic improvements in the past year. The clinic ratings are posted on the group's website, www.mnhealthcare.org.

Critics say such rankings can be unfair because they don't take into account different patient populations, who may have more complex illnesses and fewer resources to help them cope.

The report measures how many diabetic patients in each clinic met five specific goals: controlling their blood sugar, blood pressure and cholesterol levels, taking aspirin every day and not smoking.

Those steps are considered key to keeping diabetes under control and preventing complications, according to experts.

This is the second year that the group has released individual clinic ratings for diabetes, and the first year for vascular care.

The study found that 7 percent to 62 percent of patients with vascular disease (such as coronary artery disease) received "optimal care," depending on the clinic. In this case, optimal care is defined the same as for diabetes, minus the blood-sugar measurement.

The fact that the numbers vary so widely shows that "clinics across the region are not equally successful at helping patients achieve good control of diabetes and vascular disease," the group said in a statement released Monday.

But Mary Koppel, a spokeswoman for the University of Minnesota physicians, said there are other reasons that some clinics have low ratings. Many poor patients have a hard time controlling diabetes because of difficulties with access to care and healthier foods, she said. "It's important to recognize the complexity of the people coming in the door when we're doing these measurements."

The Aspen clinics, which had some of the lowest ratings, should improve their scores once they shift to electronic medical records, said David Kanihan, a spokesman for Allina. He noted that Allina, which recently bought Aspen, has made diabetes care a priority, and that electronic records "will make it easier for them both to keep track of what they're doing and also to do this better."

The new report found that clinics with electronic medical records scored 7 percent higher than those with paper files. Chase said that electronic records can help remind clinics when patients need follow-up care. He said the clinics with the most success are reaching out to patients to make sure they get care, rather than waiting for them to show up. "That's why we're seeing these big improvements," he said.

Maura Lerner • 612-673-7384

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