{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T20:08:21Z","timestamp":1771877301433,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,11,13]],"date-time":"2016-11-13T00:00:00Z","timestamp":1478995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R21 HS021899"],"award-info":[{"award-number":["R21 HS021899"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01 HS018368"],"award-info":[{"award-number":["R01 HS018368"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR000427"],"award-info":[{"award-number":["UL1TR000427"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["T32HP10010"],"award-info":[{"award-number":["T32HP10010"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1 TR000002"],"award-info":[{"award-number":["UL1 TR000002"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["KL2 TR000134"],"award-info":[{"award-number":["KL2 TR000134"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To find clinically relevant combinations of chronic conditions among patients with diabetes and to examine their relationships with six diabetes quality metrics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources\/Study Setting<\/jats:title><jats:p>Twenty\u2010nine thousand five hundred and sixty\u2010two adult patients with diabetes seen at eight Midwestern U.S. health systems during 2010\u20132011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>We retrospectively evaluated the relationship between six diabetes quality metrics and patients' combinations of chronic conditions. We analyzed 12 conditions that were concordant with diabetes care to define five mutually exclusive combinations of conditions (\u201cclasses\u201d) based on condition co\u2010occurrence. We used logistic regression to quantify the relationship between condition classes and quality metrics, adjusted for patient demographics and utilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection<\/jats:title><jats:p>We extracted electronic health record data using a standardized algorithm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>We found the following condition classes: severe cardiac, cardiac, noncardiac vascular, risk factors, and no concordant comorbidities. Adjusted odds ratios and 95 percent confidence intervals for glycemic control were, respectively, 1.95 (1.7\u20132.2), 1.6 (1.4\u20131.9), 1.3 (1.2\u20131.5), and 1.3 (1.2\u20131.4) compared to the class with no comorbidities. Results showed similar patterns for other metrics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients had distinct quality metric achievement by condition class, and those in less severe classes were less likely to achieve diabetes metrics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.12607","type":"journal-article","created":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T06:30:51Z","timestamp":1479191451000},"page":"450-468","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Stratifying Patients with Diabetes into Clinically Relevant Groups by Combination of Chronic Conditions to Identify Gaps in Quality of Care"],"prefix":"10.1111","volume":"53","author":[{"given":"Elizabeth M.","family":"Magnan","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine University of California, Davis 4860 Y Street, Suite 2320 Sacramento CA 95817"},{"name":"Health Innovation Program University of Wisconsin School of Medicine and Public Health Madison WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M.","family":"Bolt","sequence":"additional","affiliation":[{"name":"Department of Educational Psychology University of Wisconsin\u2010Madison Madison WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert T.","family":"Greenlee","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Population Health Marshfield Clinic Research Foundation Marshfield WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Fink","sequence":"additional","affiliation":[{"name":"Department of Health Informatics and Administration College of Health Sciences University of Wisconsin\u2013Milwaukee Milwaukee WI"},{"name":"Center for Urban Population Health Milwaukee WI"},{"name":"Aurora Research Institute Aurora Health Care Milwaukee WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Health Innovation Program University of Wisconsin School of Medicine and Public Health Madison WI"},{"name":"Department of Population Health Sciences University of Wisconsin School of Medicine and Public Health Madison WI"},{"name":"Department of Family Medicine University of Wisconsin School of Medicine and Public Health Madison WI"},{"name":"Department of Surgery University of Wisconsin School of Medicine and Public Health Madison WI"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,11,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-S011"},{"issue":"1","key":"e_1_2_6_3_1","doi-asserted-by":"crossref","first-page":"S60","DOI":"10.2337\/dc16-S011","article-title":"Cardiovascular Disease and Risk Management (Standards of Diabetes Care)","volume":"39","author":"American Diabetes Association","year":"2016","journal-title":"Diabetes Care"},{"issue":"1","key":"e_1_2_6_4_1","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.2337\/dc16-S004","article-title":"Strategies for Improving Care (Standards for Diabetes Care)","volume":"39","author":"American Diabetes Association","year":"2016","journal-title":"Diabetes Care"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-008-0784-9"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1643"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2010.02.018"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1671"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.492843"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1410790"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39201.463819.2C"},{"key":"e_1_2_6_12_1","volume-title":"HCUP Chronic Condition Indicator (Release)","author":"Healthcare Cost and Utilization Project","year":"2011"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.20.6.267"},{"key":"e_1_2_6_14_1","volume-title":"The Faces of Medicaid II: Recognizing the Care Needs of People with Multiple Chronic Conditions","author":"Kronick R. 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