MEASURING THE QUALITY OF CARE FOR DIABETES

大约有 1600 万美国人患有糖尿病 - 据​​估计其中一半患有未确诊的疾病。 糖尿病对低收入和少数族裔人口的影响尤为严重，是总统消除健康方面的种族和民族差异倡议的六个目标条件之一。虽然糖尿病有可能导致严重且持久的健康并发症，但这种情况可以通过门诊得到很好的控制。 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。 糖尿病治疗不当会带来很高的潜在成本，因此提高糖尿病门诊服务的质量成为当务之急。 为了改善糖尿病患者接受的护理，有必要以低成本定期监测多种环境下的护理质量。这项研究将使用来自 6 个州的医疗补助 SMRF 数据集来开发一个基于索赔和行政记录的系统，用于衡量糖尿病护理的质量。 这项研究将： 1. 根据索赔文件中报告的信息制定一套针对糖尿病的优质护理措施。 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护理的其他结果（例如住院治疗）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.