Out of six domains of care proposed by the National Committee for Quality Assurance (NCQA), the current paper focuses on such domains as the effectiveness of care. Within this domain, the author analyzes such a performance measure as comprehensive diabetes care (CDC). The efficiency of the outcomes for the CDC could be easily measured by taking blood tests and the blood pressure of a patient. For example, if hemoglobin A1c and low-density lipoprotein cholesterol levels return to normal, the treatment could be considered effective. From this, it could be inferred that the measurement tool to track patient outcomes is blood tests.
In addition to that, a person could be asked to fill out the survey on his subjective view on the efficiency of treatment. The first intervention for the CDC deals with the education of patients on their illness. It is necessary to enlighten patients about diabetes because the quality of their life and the effectiveness of the treatment to a great extent depends on their awareness of the causes and consequences of this disease. More precisely, it is essential to explain why an active lifestyle is vital for them, what food to prefer, and what could happen if they disobey recommendations. Besides, the study conducted by Kim (2016) reveals that the glycemic control of patients who conducted diabetes education was better than that of those who did not. The comorbidities of diabetes that appeared because of the inability of a patient’s body to produce the required amount of insulin are blindness, amputation of lower limbs, and disease of the kidneys and nervous system, to name but a few. This way, diabetes education is also a way to prevent patients from developing co-occurring severe diseases.
The second intervention that could help increase the efficiency of the CDC is to regularly check not only hemoglobin A1c but also blood pressure and lipid metabolism. This intervention is justified by the fact that diabetes significantly increases the risk for cardiovascular disease and stroke (American Diabetes Association, 2016; NCQA, 2019). Increased probability of the development of cardiovascular disease also means that nurses and doctors should devote attention to reducing the body mass index of overweight patients with diabetes and changing their lifestyles to a healthier ones. The third intervention is the prescription of glucose-lowering medications and control of their proper intake. Medications can be taken either orally or injected, but the second option is not required in the early stages of diabetes mellitus. Still, the problem with insulin needed for patients diagnosed with diabetes mellitus is that it cannot be absorbed orally and, hence, should be injected (Okur, Karantas, and Siafaka, 2017).
Therefore, it is necessary to regularly check if oral medications work or whether it is time to prescribe injections to a patient. The primary care interventions described above will improve patient outcomes and lead to health care cost savings. Education of patients on diabetes, the simultaneous focus on the prevention of cardiovascular disease, and control over the effectiveness of the prescribed medications guarantee a better quality of life for a patient and minimize the risk for the development of numerous co-occurring diseases. The progress will be apparent not only from the improved blood tests of patients but also from the rise in their daily activity levels and a healthier lifestyle. The major reason why the proposed interventions will save health care costs lies in diabetes comorbidities. If a patient with diabetes mellitus gets kidney disease or stroke or loses sight, he will require additional healthcare services. In other words, ineffective treatment fails to minimize the risk of developing other diseases, and, consequently, more resources should be allocated to treat such a patient in the future.
Suppose a healthcare specialist provides a one-sided treatment that focuses only on the decrease of the blood sugar level. In that case, the healthcare system will suffer additional costs later because a patient will require treatment for one or several other health issues. NP patient ratings show the extent of patient satisfaction with treatment outcomes and the performance of nurses and physicians. Apart from the benefits described above, the proposed interventions could increase NP patient ratings. First of all, these interventions illustrate a patient-centered approach. It is impossible to implement the previously mentioned interventions without focusing on each case individually and independently from others instead of following standard procedures.
However, it does not mean that standard procedures are harmful; instead, they are based on evidence and experience and are effective. Still, the point is that one person needs some additional interventions to prevent kidney or heart diseases, whereas another person needs to lose weight. Therefore, the treatment plans of these people should be different and should be focused on their unique requirements and health issues as well. Another reason why proposed interventions will increase NP patient ratings is the higher efficiency of the treatment. This point is closely related to the previous one. The patient-centered approach is the underpinning assumption of effective and comprehensive care of any disease, including diabetes of both types. The interventions guarantee that the medications are chosen correctly and that the practitioner worries not only about the blood glucose level but also about the overall health status of a patient.
References
American Diabetes Association (2016). 1. Strategies for improving care. Diabetes Care, 39 (Supplement 1), S6-S12.
Kim, S. H. (2016). Educational attainment moderates the associations of diabetes education with health outcomes. International Journal of Nursing Practice, 22(5), 444-450.
National Committee for Quality Assurance [NCQA] (2019). Comprehensive Diabetes Care (CDC).
Okur, M. E., Karantas, I. D., & Siafaka, P. I. (2017). Diabetes Mellitus: a review on pathophysiology, current status of oral pathophysiology, current status of oral medications and future perspectives. ACTA Pharmaceutica Sciencia, 55(1), 61-82.