MEASURING THE QUALITY OF CARE FOR DIABETES

大约有1600万美国人患有糖尿病，其中一半的人估计患有未确诊的疾病。糖尿病对低收入和少数群体的影响尤为严重，是总统提出的“消除健康种族差异倡议”中的6个目标疾病之一。虽然糖尿病有潜在的严重和长期的健康并发症，这种情况可以在门诊的基础上得到很好的管理。糖尿病治疗的特点是关于适当护理内容的明确指南，以及在实践中遵守这些指南的程度存在很大差异。糖尿病治疗不充分会带来很高的潜在成本，这使得提高糖尿病门诊服务质量成为一个优先事项。为了改善糖尿病患者接受的护理，有必要在许多环境中以常规和低成本监测护理质量。本研究将使用来自6个州的医疗补助SMRF数据集来开发一个基于索赔和管理记录的系统，以衡量糖尿病护理的质量。本研究将：1。根据索赔文件中报告的信息，制定一套针对糖尿病的高质量护理措施。2. 评估这些措施反映护理质量变化的能力。3. 确定与糖尿病医疗补助患者接受的护理质量变化相关的患者和环境特征。4. 通过证明这些措施与糖尿病治疗的其他结果（如住院治疗）相关来验证这些措施。

Approximately 16 million Americans suffer from diabetes - one half of them estimated to have undiagnosed disease. Diabetes disproportionately affects low-income and minority populations and is one of the six target conditions under the President s Initiative to Eliminate Racial and Ethnic Disparities in Health. While diabetes has to potential for severe and long-lasting health complications, the condition can be well-managed on an ambulatory basis. Treatment of diabetes is marked by clear guidelines on the appropriate content of care, and wide variation in the extent to which these guidelines are adhered to in practice. There are high potential costs associated with inadequately treated diabetes, which makes improving quality of ambulatory services for diabetes a priority. In order to improve the care received by patients with diabetes, it is necessary to monitor the quality of care across many settings, routinely and at low cost. This research will use the Medicaid SMRF data sets from 6 states to develop a claims and administrative record-based system for measuring the quality of diabetes care. This study will: 1. Develop a set of quality care measures for diabetes based on information reported in claims files. 2. Assess the ability of these measures to reflect variations in the quality of care. 3. Identify patient and environmental characteristics that correlate with variations in the quality of care received by diabetic Medicaid patients. 4. Validate these measures by showing they are associated with other outcomes for diabetes care, such as hospitalization.