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Trends over 8 years in quality of diabetes care: results of the AMD Annals continuous quality improvement initiative
- Source :
- Acta Diabetologica. 52:557-571
- Publication Year :
- 2014
- Publisher :
- Springer Science and Business Media LLC, 2014.
-
Abstract
- Quality of care monitoring is a key strategy for health policy. In Italy, the AMD Annals continuous monitoring and quality improvement initiative has been in place since 2006. Results after 8 years are now available.Quality of diabetes care indicators during the years 2004-2011 were extracted from electronic medical records of 300 diabetes clinics. From 200,000 to 500,000 patients with type 2 diabetes were analyzed per year. Six process indicators, eight intermediate outcome indicators, seven indicators of treatment intensity/appropriateness, and a quality of care summary score (Q score) were evaluated. Previous studies documented that the risk of developing a new cardiovascular event was 80 % higher in patients with a Q score15 and 20 % higher in those with a score between 15 and 25, as compared to those with a score25.The proportion of patients with HbA1c ≤7 %, LDL cholesterol100 mg/dl, and blood pressure ≥140/90 mmHg increased by 4.8, 21.9, and 10.0 %, respectively. Process and treatment intensity/appropriateness indicators consistently improved. The proportion of patients with a Q score15 decreased from 13.5 to 6.5 %, while those with a Q score25 increased from 22.9 to 38.5 %.AMD Annals document the progress in quality of diabetes care. Longitudinal improvements in Q score can translate into less cardiovascular events, with evident clinical and economic implications. AMD Annals represent a physician-led effort not requiring allocation of extra-economic resources, which is easy to implement and deeply rooted in routine clinical practice. They are a potential case model for other healthcare systems.
- Subjects :
- Treatment intensity/appropriatene
Male
Gerontology
Diabetes mellitu
medicine.medical_specialty
Quality management
Electronic medical record
Endocrinology, Diabetes and Metabolism
media_common.quotation_subject
Blood Pressure
Type 2 diabetes
Q Score
Outcome measure
Endocrinology
Diabetes mellitus
Internal Medicine
medicine
Humans
Quality (business)
Health policy
Aged
Quality of Health Care
media_common
Glycated Hemoglobin
business.industry
Medical record
Quality of care
Cholesterol, LDL
General Medicine
Middle Aged
medicine.disease
Quality Improvement
Annals
Diabetes Mellitus, Type 2
Italy
Process measure
Family medicine
Female
Patient Care
business
Subjects
Details
- ISSN :
- 14325233 and 09405429
- Volume :
- 52
- Database :
- OpenAIRE
- Journal :
- Acta Diabetologica
- Accession number :
- edsair.doi.dedup.....21383ef7a6f9c13f9d852bf1be9ee505