Diabetes Mellitus Clinical Trial
Official title:
Evaluation of Quality of Care - Risk Assessment Management Programme, HA
Diabetes mellitus (DM) is one of the major cause of morbidity and among the top 10 causes of
deaths in Hong Kong in 2008 (Department of Health 2009). The Hospital Authority (HA) has
initiated service improvement through introducing the risk assessment and management
programme (RAMP) to improve the quality of care (QOC) for DM patients in general outpatient
clinics (GOPC). The evaluation on the QOC is an essential part of the programme in order to
inform future policy. The Department of Family Medicine and Primary Care (FMPC) of the
University of Hong Kong (HKU) has been appointed by the HA to carry out the evaluation of the
QOC of the programme.
The Action Learning and Audit Spiral methodologies to measure whether the target standard of
care intended by the RAMP programme is achieved. Each RAMP participating clinic and hospital
will be invited to complete a structured evaluation questionnaire. The data of all patients
who have enrolled into the RAMP for more than one year will be included in the evaluation on
the process and outcomes of care.
One thousand two hundred and forty-eight age and disease matched control patients who have
not been enrolled into the RAMP programme will be selected for the comparison in the outcomes
of care. A hundred and thirty participants will be followed up by telephone to evaluate the
effect of the programme in quality of life (QOL), patient enablement, and global rating of
change in health condition at baseline and 6 months after enrolment. Data on the process of
care will be retrieved from the HA medical records.
Main Outcome Measures: The primary outcomes are the proportion of participants who have
received the criterion process of care, and achieved the target HbA1c and blood pressure
levels.
Data Analysis: Descriptive statistics on proportions of centers or subjects meeting the QOC
criteria will be calculated. The changes in the clinical and patient reported outcomes of
RAMP subjects will be compared at 12, 24, 36 and 48 months will be compared by paired sample
t-test. The clinical outcomes between RAMP subjects and control group will be compared by
independent sample t-test or Chi-square test.
Results: The QOC of the RAMP programme will be determined. Areas of deficiency and possible
areas for quality enhancement will be identified.
Conclusion: The results of this study will provide empirical evidence on whether the HA's
RAMP programme can achieve improvement in QOC for DM patients. The information will be used
to guide service planning and policy decision making.
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