{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T22:53:04Z","timestamp":1765839184283,"version":"3.48.0"},"reference-count":22,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,4,13]]},"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To enhance the quality of diabetes care in the Netherlands, so-called care groups with three to 250 general practitioners emerged to organise and coordinate diabetes care. This introduced a new quality management level in addition to the quality management of separate general practices. We hypothesised that this new level of quality management might be associated with the aggregate performance indicators on the patient level. Therefore, we aimed to explore the association between quality management at the care group level and its aggregate performance indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All Dutch care groups (n=97).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>23 care groups provided aggregate register-based performance indicators of all their practices as well as data on quality management measured with a questionnaire filled out by 1 or 2 of their quality managers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcomes<\/jats:title>\n                    <jats:p>The association between quality management, overall and in 6 domains (\u2018organisation of care\u2019, \u2018multidisciplinary teamwork\u2019, \u2018patient centredness\u2019, \u2018performance management\u2019, \u2018quality improvement policy\u2019 and \u2018management strategies\u2019) on the one hand and 3 process indicators (the percentages of patients with at least 1 measurement of glycated haemoglobin, lipid profile and systolic blood pressure), and 3 intermediate outcome indicators (the percentages of patients with glycated haemoglobin below 53\u2005mmol\/mol (7%); low-density lipoprotein cholesterol below 2.5\u2005mmol\/L; and systolic blood pressure below 140\u2005mm\u2005Hg) by weighted univariable linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The domain \u2018management strategies\u2019 was significantly associated with the percentage of patients with a glycated haemoglobin &lt;53\u2005mmol\/mol (\u03b2 0.28 (0.09; 0.46) p=0.01) after correction for multiple testing. The other domains as well as overall quality management were not associated with aggregate process or outcome indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This first exploratory study on quality management showed weak or no associations between quality management of diabetes care groups and their performance. It remains uncertain whether this second layer on quality management adds to better quality of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-007456","type":"journal-article","created":{"date-parts":[[2015,5,12]],"date-time":"2015-05-12T20:31:26Z","timestamp":1431462686000},"page":"e007456","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Association between quality management and performance indicators in Dutch diabetes care groups: a cross-sectional study"],"prefix":"10.1136","volume":"5","author":[{"given":"Marjo J E","family":"Campmans-Kuijpers","sequence":"first","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline A","family":"Baan","sequence":"additional","affiliation":[{"name":"Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lidwien C","family":"Lemmens","sequence":"additional","affiliation":[{"name":"Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, Bilthoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten L H","family":"Klomp","sequence":"additional","affiliation":[{"name":"Care Group \u201cDe Ondernemende Huisarts\u201d, Eindhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnold C M","family":"Romeijnders","sequence":"additional","affiliation":[{"name":"Care Group PoZoB, Veldhoven, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy E H M","family":"Rutten","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,5,11]]},"reference":[{"key":"2025121514511660000_5.5.e007456.1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1093\/oxfordjournals.intqhc.a002606","article-title":"Community-based integrated care: myth or must?","volume":"14","author":"Plochg","year":"2002","journal-title":"Int J Qual Health Care"},{"key":"2025121514511660000_5.5.e007456.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199610103351511"},{"key":"2025121514511660000_5.5.e007456.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1011849"},{"key":"2025121514511660000_5.5.e007456.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1009380"},{"key":"2025121514511660000_5.5.e007456.5","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/S0140-6736(11)61088-X","article-title":"What are the lessons from the USA for clinical commissioning groups in the English National Health Service?","volume":"379","author":"Ham","year":"2012","journal-title":"Lancet"},{"key":"2025121514511660000_5.5.e007456.6","unstructured":"Struijs JN , Mohnen SM , Molema CCM , et al . 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