Quality improvement in diabetes--successful in achieving better care with hopes for prevention.
Diabetes affects 29 million Americans and is associated with billions of dollars in health expenditures and lost productivity. Robust evidence has shown that lifestyle interventions in people at high risk for diabetes and comprehensive management of cardiometabolic risk factors like glucose, blood pressure, and lipids can delay the onset of diabetes and its complications, respectively. However, realizing the "triple aim" of better health, better care, and lower cost in diabetes has been hampered by low adoption of lifestyle interventions to prevent diabetes and poor achievement of care goals for those with diabetes. To achieve better care, a number of quality improvement (QI) strategies targeting the health system, healthcare providers, and/or patients have been evaluated in both controlled trials and real-world programs, and have shown some successes, though barriers still impede wider adoption, effectiveness, real-world feasibility, and scalability. Here, we summarize the effectiveness and cost-effectiveness data regarding QI strategies in diabetes care and discuss the potential role of quality monitoring and QI in trying to implement primary prevention of diabetes more widely and effectively. Over time, achieving better care and better health will likely help bend the ever-growing cost curve.
School of Medicine.
J Sonya
JS
Haw
School of Medicine.|Rollins School of Public Health, Emory University, Atlanta, Georgia.
K M Venkat
KM
Narayan
Rollins School of Public Health, Emory University, Atlanta, Georgia.
Mohammed K
MK
Ali
D003363:Cost Control; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D058996:Quality Improvement
diabetes care; diabetes mellitus; diabetes prevention; quality improvement