Comparison of clinical-metabolic monitoring and outcomes and coronary risk status in people with type 2 diabetes from Australia, France and Latin America.
OBJECTIVE
To compare clinical-metabolic monitoring and coronary risk status in people with type 2 diabetes from Australia, France and Latin America.


METHODS
Retrospective analysis of data collected at primary care (except ANDIAB--secondary care) [corrected] matched for age, gender and disease duration. Measurements included participants' characteristics, performance frequency of clinical-metabolic process indicators, and percentage of clinical-metabolic outcomes at recommended target values.


RESULTS
The weighted mean of the percentage of process performance was within 68 to 81%; that of outcomes at target dropped to 29 to 45%. Although statistically significant, differences among groups were far from those in healthcare budgets, and probably only of marginal clinical impact. The percentage of patients with low, slight or high coronary risk was similar in the three groups, with most people at high or very high risk.


CONCLUSIONS
Despite the high difference in health per capita investment and system characteristics among countries, the study populations had striking similarities regarding the low percentage of participants who achieved cardiovascular risk factor and diabetes treatment goals. Therefore, differences in health budget and system characteristics would not be the main drivers in care quality. Diabetes education at every level and quality care registries would contribute to improve this situation and assess such improvement.
Center of Experimental and Applied Endocrinology (CENEXA, National University of La Plata-National Research Council of La Plata), PAHO/WHO Collaborating Center for Diabetes Research, Education, and Care, La Plata, Argentina. cenexa@speedy.com.ar
Juan J
JJ
Gagliardino
Line
L
Kleinebreil
Stephen
S
Colagiuri
Jeff
J
Flack
Joaquín E
JE
Caporale
Fernando
F
Siri
Charles
C
Clark
D000368:Aged; D000704:Analysis of Variance; D001315:Australia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005602:France / Q000453:epidemiology; D015438:Health Behavior; D006296:Health Services / Q000191:economics; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation / Q000191:economics; D011787:Quality of Health Care / Q000191:economics; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment; D012648:Self Care / Q000191:economics; D016896:Treatment Outcome