Community Programs Linked to Clinical Services - Self-Management
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SELF-MANAGEMENT DIABETES SELF-MANAGEMENT EDUCATION AND TRAINING

STRATEGY LIST

1305 Basic

Strategy 7: Promote participation in ADA-recognized, AADE-accredited, state accredited/certified, and/or Stanford licensed diabetes self-management education (DSME) programs (See also Bi-directional Referral System)

Performance Measure B.7.01

Proportion of people with diabetes in targeted settings who have at least one encounter at an ADA-recognized, AADE-accredited, state accredited/certified, and/or Stanford licensed DSME program


The purpose of this performance measure is to measure the number of encounters that people with diabetes have at DSME programs. Diabetes self-management education (DSME) offered in community gathering places is effective in improving glycemic control for adults with type 2 diabetes (Norris et al., 2002). Participation in diabetes self-management education is associated with increased use of primary and preventive services and lower use of acute, inpatient hospital services (Duncan 2009). Increasing the number of encounters that people with diabetes have at DSME programs in clinic and community settings increases the likelihood of improved health outcomes.

 

1305 Enhanced

Strategy 1: Increase use of diabetes self-management programs in community settings

Intervention: Increase access, referrals, and reimbursement for AADE-accredited, ADA-recognized, State-accredited/certified, or Stanford-licensed DSME programs(See also Bi-directional Referral System)

Short-term:

Performance Measure 4.1.01

Number of ADA recognized, AADE accredited/certified DSME programs during the funding year


The purpose of this performance measure is to measure the increased use of AADE-accredited, ADA-recognized and/or State-accredited/certified diabetes self-management programs (DSME) in community settings.


Diabetes self-management education (DSME) offered in community gathering places is effective in improving glycemic control for adults with type 2 diabetes (Norris et al., 2002). Participation in diabetes self-management education is associated with increased use of primary and preventive services and lower use of acute, inpatient hospital services (Duncan 2009). Studies found participation in DSME increases in underserved communities with the establishment of new self-management education programs (Balamurugan et al., 2006). Increasing the number of DSME Programs in clinic and community settings can increase the number of people with diabetes with access to these services.

 

Performance Measure 4.1.02

Number of Stanford DSMP workshops offered during the funding year


The purpose of this performance measure is to measure the number of Stanford diabetes self-management program (DSMP) workshops in community settings.

 

Performance Measure 4.1.03

Proportion of counties with ADA recognized, AADE accredited, or state accredited/certified DSME programs


The purpose of this performance measure is to measure the proportion of counties in a state with AADE-accredited, ADA-recognized, or State-accredited/certified DSME programs.

 

Performance Measure 4.1.04

Proportion of counties with Stanford DSMP workshops


The purpose of this performance measure is to measure the proportion of counties in a state offering Stanford diabetes self-management program (DSMP) workshops.

 

Performance Measure 4.1.05

Number of Medicaid recipients with diabetes who have DSME as a covered Medicaid benefit


The purpose of this performance measure is to assess grantee efforts to increase Medicaid coverage for diabetes self-management education (DSME). Participation in DSME is associated with increased use of primary and preventive services, lower use of acute inpatient hospital services, increased diabetes knowledge, improved self-care behaviors, and improved glycemic control for adults with type 2 diabetes (ADA 2012, Duncan 2009, Norris 2002). Improved insurance coverage of DSME programs is needed to help ensure that people with diabetes receive self-management education and support (Carpenter 2012, Peyrot 2009). Public and private coverage of DSME is limited and Medicaid coverage of DSME varies by state (Carpenter 2012). Limited insurance coverage may make DSME programs unaffordable for some persons with diabetes, particularly those of low economic status (Carpenter 2012, Eakin 2002, Tripp-Reimer 2001).

 

Intermediate:

Performance Measure 4.1.06

Proportion of people with diabetes in targeted settings who have at least one encounter at an ADA recognized, AADE accredited, state accredited/certified, and/or Stanford licensed DSME program during the funding year


The purpose of this performance measure is to measure the number of encounters that people with diabetes have at DSME programs. Diabetes self-management education (DSME) offered in community gathering places is effective in improving glycemic control for adults with type 2 diabetes (Norris et al., 2002). Participation in diabetes self-management education is associated with increased use of primary and preventive services and lower use of acute, inpatient hospital services (Duncan 2009). Increasing the number of encounters that people with diabetes have at DSME programs in clinic and community settings increases the likelihood of improved health outcomes.

 

Long-term:

Performance Measure 4.1.07 (3.1.11; 3.2.11; 4.3.09)

Decreased proportion of people with diabetes with A1C > 9


The purpose of this performance measure is to monitor changes in the proportion of people with diabetes with poor glycemic control (HbA1c > 9%) and at greatest risk of diabetes complications. The Diabetes Control and Complications Trial (DCCT Research Group, 1993), the UK Prospective Diabetes Study Group (Stratton et al., 2000) and subsequent clinical trials (Ismail-Beigi et al., 2010) found increased risk of microvascular complications (retinopathy and nephropathy), with higher HbA1c levels. To reduce the risk of complications the American Diabetes Association recommends a HbA1c < 7% with testing at least two times per year for those in control and quarterly for those not in control to reduce the risk of complications (ADA, 2014).

 

Performance Measure 4.1.08 (3.1.12; 3.2.12; 4.4.04)

Age-adjusted hospital discharge rate for diabetes as any-listed diagnosis per 1,000 persons with diabetes


The purpose of this performance measure is to assess the prevalence of diabetes-related hospital discharges in the population of people with diabetes, as a long term effect of interventions to increase implementation of quality improvement processes, team-based care in health systems, and the use of diabetes and chronic disease self-management programs in community settings.