Baseline Quality-of-Care Data From a Quality-Improvement Program Implemented by a Network of Diabetes Outpatient Clinics

  1. Maria C.E. Rossi, MSC1,
  2. Antonio Nicolucci, MD1,
  3. Adolfo Arcangeli, MD2,
  4. Antonino Cimino, MD3,
  5. Gualtiero De Bigontina, MD4,
  6. Carlo Giorda, MD5,
  7. Illidio Meloncelli, MD6,
  8. Fabio Pellegrini, MSC1,
  9. Umberto Valentini, MD3,
  10. Giacomo Vespasiani, MD6 and
  11. on behalf of the Associazione Medici Diabetologi (AMD) Annals Study Group*
  1. 1Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro (CH), Italy
  2. 2A.S. Diabetes and Metabolic Diseases, AUSL 4, Prato, Italy
  3. 3Diabetes Unit, A.O. Spedali Civili Brescia, Italy
  4. 4Diabetes Unit, Cadore Hospital, Dolomiti-Belluno, Italy
  5. 5Diabetes and Metabolism Unit, Chieri (TO), Italy
  6. 6Diabetes Unit, “Madonna del Soccorso” Hospital, San Benedetto del Tronto (AP), Italy
  1. Corresponding author: Maria C. Rossi, mrossi{at}negrisud.it

Abstract

OBJECTIVE—To describe patterns of diabetes care and implement benchmarking activities at the national level.

RESEARCH DESIGN AND METHODS—A total of 86 clinics participated, all using electronic medical records. Quality indicators were identified, and software was developed, enabling the extraction of the information needed for quality-of-care profiling.

RESULTS—Overall, 114,249 patients with type 2 diabetes were seen during 2004. A1C was measured at least once in 88.0% of the patients, lipid profile in 64.6%, blood pressure in 77.2%, and microalbuminuria in 48.1%. Overall, 43.1% of individuals had A1C ≤7.0%, 36.6% had blood pressure ≤130/85 mmHg, and 29.8% had LDL cholesterol <100 mg/dl. Only 5.5% of the patients had achieved all the favorable outcomes. Wide between-center variation was documented for all indicators.

CONCLUSIONS—This study is the first step of a nationwide quality-improvement effort and documents the possibility of obtaining standardized information to be used for diabetes care profiling and benchmarking activities.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 11 August 2008.

  • *

    ↵* A complete listing of the Associazione Medici Diabetologi (AMD) Annals Study Group is available in an online appendix at http://dx.doi.org/10.2337/dc08-0469.

  • Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted August 1, 2008.
    • Received March 6, 2008.
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  1. Published online before print August 11, 2008, doi: 10.2337/dc08-0469 Diabetes Care November 2008 vol. 31 no. 11 2166-2168
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