This project examined the policy implications of current approaches, characteristics, and effectiveness of diabetes care management and quality improvement programs in rural areas. Diabetes is a well-understood disease for which there has been a reasonably large amount of program development in rural areas involving care management, self-management, and prevention, or combinations of these elements. Diabetes programs represent, therefore, a sound starting point for understanding the rural context, process, structure, barriers, and operational and performance results of chronic disease management and quality improvement programming in rural areas.

This project focused specifically on diabetes care management and quality improvement programming in rural areas to better understand the adaptability and policy implications of using chronic care coordination and other models in a rural environment.

The following hypotheses will be researched:

• Early adoption and success are more likely when there is active leadership, existing collaborative relationships such as alliances and networks, strong links to community-based resources needed for care management, active participation of the Quality Improvement Organization, and support from state professional associations.
• The greater the distance that diabetes care programs are from urban counties the less likely the use of certified diabetes education and the less likely the program to be sustained.

Publications

• Chronic Disease Management Systems (Registries) in Rural Health Care
  Policy Brief
  RUPRI Center for Rural Health Policy Analysis
  Date: 05/2006
  A Chronic Disease Management System (CDMS) is a tool that helps providers collect and analyze patient information to promote quality care. This study shows that CDMSs are readily available to rural clinics and are being implemented and maintained by clinic staff with minimal expenditures for technology.
• Elements of Successful Rural Diabetes Management Programs
  RUPRI Center for Rural Health Policy Analysis
  Date: 07/2006
  This report shares findings from a study about local innovations implemented by rural chronic disease management programs. Using diabetes as a proxy for all chronic diseases, the authors explored how local innovations overcame challenges of the rural setting to provide effective and efficient disease management.