What and Who does the Community Health Checkup Include?

This first Community Health Checkup includes region-wide and clinical practice-level information about how Greater Cleveland’s participating primary care practices are doing in the care and outcomes of their adult patients with diabetes.

Collectively, data were submitted, analyzed, and reviewed by 6 health care organizations which care for approximately 25,000 patients with diabetes. Three of the organizations, representing 30 group practices throughout the Greater Cleveland area (Cleveland Clinic, MetroHealth, and Kaiser Permanente), obtained data from their electronic medical records (EMRs) and related registries; the other three are Federally Qualified Health Centers (Neighborhood Family Practice, Northeast Ohio Neighborhood Health Services, Inc. [NEON], and Care Alliance), which used their diabetes patient registries to identify random samples of 50 patients for detailed review of their paper-based medical records.

All practices used agreed-upon definitions for diabetes and the patients with diabetes who were eligible to be reviewed and reported. Patients included in the reports were between 18 and 75 years of age and were seen in the practice by a primary care physician at least twice in calendar year 2007. Specific measures and our standards for achievement are described in detail in section D.

For the Community Health Checkup to accurately describe care across all types of patients in the region, we also obtained information from participating practices that enables us to describe our results categorized according to patients’ insurance status, race, estimated household income, and estimated maximum educational attainment. To categorize by insurance, we identified each patient’s primary insurer as Medicare, a Commercial insurer, Medicaid, or that he/she had no insurance (was classified by the practice as “self-pay” or uninsured). Race was categorized as white, African American, Hispanic, or Other by patient self-report to their practice. Household income and educational attainment were estimated by obtaining census data from the vicinity around the patient’s home. Unique strengths and special limitations of our approaches for measurement are described in more detail in section D. 3.