– illustrated by benchmarking of real-world treatment outcomes in type 2 diabetes
Background Value-based health care shifts the focus to real-world treatment outcomes. The aim of the study was to illustrate how use of the funnel plot method (FPM) can contribute to the value-based improvement of primary care services. Benchmarking of real-world health-centre-specific treatment outcomes in type 2 diabetes is used as an example.
Methods The study cohort consisted of patients with type 2 diabetes who had visited health centres in the Siun sote area in 2014–2018 (n = 7,119 to 7,946). The outcome indicators used were adjusted health-centre-specific mean HbA 1c values (mmol/mol), and the proportion of patients with HbA1c < 53 mmol/mol and HbA 1c > 75 mmol/mol.
Results Special cause variation from the treatment target level was observed in the period studied. However, the proportions of patients with good glycaemic control (i.e. 65.7% to 68.4%) and with particularly poor glycaemic control (i.e. 5.6% to 7.2%) stayed relatively constant.
Conclusions The FPM provides a visual and easy-to-interpret way to compare health-centre-specific real-world treatment outcomes, as well as to improve the quality, effectiveness, and cost-effectiveness of services.
Janne Martikainen
Professor
University of Eastern Finland, School of Pharmacy, Pharmacoeconomics & Outcomes Research Unit
Kari Jalkanen, Jari Heiskanen, Piia Lavikainen, Petri Kivinen, Tiina Laatikainen
