What is the cost of quality for diabetes care?

Jean M. Abraham, Daniel J. Crespin, Jeffrey S. McCullough, Jon B. Christianson

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Increasing the quality of care and reducing cost growth are core objectives of numerous private- and public-sector performance improvement initiatives. Using a unique panel data set for a commercially insured population and multivariate regression analysis, this study examines the relationship between medical care spending and diabetes-related quality measures, including provider-initiated processes of care and patient-dependent quality activities. Empirical evidence generated from this analysis of the relationship between a comprehensive set of diabetes quality measures and diabetes-related spending does not lend support for the assumption that high-quality preventive and primary care combined with effective patient self-management can lead to lower costs in the near term. Finally, we find no relationship between adjusted spending and intermediate clinical outcomes (e.g., HbA1c level) measured at the clinic level.

Original languageEnglish (US)
Pages (from-to)580-598
Number of pages19
JournalMedical Care Research and Review
Issue number6
StatePublished - Dec 29 2014

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: We acknowledge the financial support of the Minnesota Medical Foundation. We also acknowledge the financial support of the Robert Wood Johnson Foundation for evaluation of the Aligning Forces for Quality Initiative.

Publisher Copyright:
© The Author(s) 2014.


  • cost
  • diabetes
  • disease management
  • employer-based population
  • quality


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