Evaluation of the quality of care for diabetic patients in Latin America

Gagliardino, Juan José; Hera, M De La; Siri, Fernando

doi:10.1590/s1020-49892001001100003

Cited by 45 publications

(37 citation statements)

References 20 publications

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“…Rates of HbA1c > 7% varied from 32% (Ireland) to 83% (Cyprus); total cholesterol > 5 mmol/l ranged from 14% (Ireland) to 68% (Cyprus); blood pressure > 140/90 mmHg, from 17% (France) to 46% (Sweden). [27] The QUALIDIAB network [29] in Argentina, Brazil, Chile, Colombia, Paraguay, and Uruguay reported that 43% of patients had blood glucose level of <7.7 mmol/L and the proportion of patients reaching combined treatment goals for blood glucose, cholesterol and blood pressure ranged from 1% in Mexico to almost 12% in the United States [30]. These variations should give rise to continued assessment and improvement efforts.…”

Section: Discussionmentioning

confidence: 99%

Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico

Pérez‐Cuevas

Doubova

Suárez-Ortega

et al. 2012

BMC Med Inform Decis Mak

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BackgroundSeveral low and middle-income countries are implementing electronic health records (EHR). In the near future, EHRs could become an efficient tool to evaluate healthcare performance if appropriate indicators are developed. The aims of this study are: a) to develop quality of care indicators (QCIs) for type 2 diabetes (T2DM) in the Mexican Institute of Social Security (IMSS) health system; b) to determine the feasibility of constructing QCIs using the IMSS EHR data; and c) to evaluate the quality of care (QC) provided to IMSS patients with T2DM.MethodsWe used a three-stage mixed methods approach: a) development of QCIs following the RAND-UCLA method; b) EHR data extraction and construction of indicators; c) QC evaluation using EHR data from 25,130 T2DM patients who received care in 2009.ResultsWe developed 18 QCIs, of which 14 were possible to construct using available EHR data. QCIs comprised both process of care and health outcomes. Several flaws in the EHR design and quality of data were identified. The indicators of process and outcomes of care suggested areas for improvement. For example, only 13.0% of patients were referred to an ophthalmologist; 3.9% received nutritional counseling; 63.2% of overweight/obese patients were prescribed metformin, and only 23% had HbA1c <7% (or plasma glucose ≤130 mg/dl).ConclusionsEHR data can be used to evaluate QC. The results identified both strengths and weaknesses in the electronic information system as well as in the process and outcomes of T2DM care at IMSS. This information can be used to guide targeted interventions to improve QC.

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Section: Discussionmentioning

confidence: 99%

Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico

Pérez‐Cuevas

Doubova

Suárez-Ortega

et al. 2012

BMC Med Inform Decis Mak

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“…In Argentina, the Health Ministry provision of economic incentives to entities of the Social Security subsector that include preventive strategies in their care programs for chronic diseases, play also in favor of this concept. This policy would be particularly important in developing countries, where the expected rise in the prevalence of diseases such as type 2 diabetes will imply an increased demand of care both in the short and long term [11,18].…”

Section: Discussionmentioning

confidence: 99%

“…Despite this strong evidence on the relationship between HF and HbA1c levels, the latter are above target values in most patients worldwide, including Argentina, [10,11]. Therefore, many HF events could be prevented in people with diabetes by improving their metabolic control, with the consequent beneficial effect for patients and the health care system.…”

Section: Introductionmentioning

confidence: 99%

Hospitalization Costs for Heart Failure in People with Type 2 Diabetes: Cost-Effectiveness of its Prevention Measured by a Simulated Preventive Treatment

Caporale¹,

Elgart²,

Pfirter³

et al. 2011

Value in Health

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“…The annual and semiannual Qualidiab data-collection forms28 and an annual personalized check-book of medical and laboratory tests and drug prescription were used to measure the following variables: demographic data, diabetes-education indicators, performance of diagnostic/control procedures, presence of acute and chronic complications (micro/macrovascular complications), hospitalization rate, and absenteeism. We also recorded clinical and therapeutic indicators of degree of control of hyperglycemia, associated CVRFs, other health conditions, and costs of care (annual consumption of diagnostic and therapeutic resources).…”

Section: Methodsmentioning

confidence: 99%

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

González¹,

Elgart²,

Calvo³

et al. 2013

CEOR

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PurposeTo measure the impact of a diabetes and cardiovascular risk factors program implemented in a social security institution upon short- and long-term clinical/metabolic outcomes and costs of care.MethodsObservational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female program participants with diabetes before (baseline) and 1 and 3 years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration’s database.ResultsThe implementation of the program in “real world” conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRFs), as well as a decrease of events related to chronic complications. This improvement was associated with an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRFs.ConclusionThe implementation of a diabetes program in real-world conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRFs, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing costs, our results suggest the need to include management-control strategies in these programs for appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.

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Evaluation of the quality of care for diabetic patients in Latin America

Abstract: Objetivos. Hacer un diagnóstico preliminar de la calidad de la atención que reciben las personas con diabetes (DM) en centros tributarios de la red QUALIDIAB y analizar el potencial de esta información y la importancia de la expansión de la red en (1,6 veces).

Cited by 45 publications

References 20 publications

Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico

Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico

Hospitalization Costs for Heart Failure in People with Type 2 Diabetes: Cost-Effectiveness of its Prevention Measured by a Simulated Preventive Treatment

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

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