Baseline quality-of-care data from a quality-improvement program implemented by a network of diabetes outpatient clinics.
OBJECTIVE
To describe patterns of diabetes care and implement benchmarking activities at the national level.


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 <or=7.0%, 36.6% had blood pressure <or=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.
Rossi
Maria C E
MC
Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S Maria Imbaro CH, Italy. mrossi@negrisud.it
Nicolucci
Antonio
A
Arcangeli
Adolfo
A
Cimino
Antonino
A
De Bigontina
Gualtiero
G
Giorda
Carlo
C
Meloncelli
Illidio
I
Pellegrini
Fabio
F
Valentini
Umberto
U
Vespasiani
Giacomo
G
D000368:Aged; D000419:Albuminuria / Q000652:urine; D000554:Ambulatory Care Facilities / Q000592:standards*; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy* / Q000652:urine; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards; D016896:Treatment Outcome
D006442:Glycated Hemoglobin; D008055:Lipids