Lege Artis Medicinae

[Standardizing the results of Diabcare Hungary; A method for comparison and quality Improvement]

TABÁK Gy. Ádám1, TAMÁS Gyula1, KERÉNYI Zsuzsa2

FEBRUARY 01, 2000

Lege Artis Medicinae - 2000;10(02)

[INTRODUCTION – DiabCare, the monitoring system of the WHO/IDF-Euro was developed for continuous quality improvement of diabetes care based on a structured and standardized diabetes dataset. PATIENTS AND METHODS - Data from 5 DiabCare Hungary centers with different patient populations were adjusted for demographic parameters and compared to the 2403 records of the national dataset collected between 1995–97. RESULTS - More than half of the investigated patients were >56 years old (centers analyzed in detail: 20–83%), one third of them had an age 36-55 years (17-52%), 45% were male (27-63%). The prevalence of type 1 DM was 29% (0–80%). Almost one third of the patients had a diabetes duration >15 years (14-58%). Eyes were examined in 79% (28-98%), retinopathy was found in 29% (28–81%, minimal change after standardization). Risk factor identification was above 80% in all centers (except in center 3: 16-94%). Rate of patients with risk factors: HbAlc >8%: 43%; triglycerides >2mmol/l: 33% (in center 5 lower, 17%; after standardization 37%), blood pressure (>160/95 Hgmm), smoking and alcohol consumption together 15%. Albuminuria was examined in 55% (25–89%), with microalbuminuria present in 24% (0-38%). The frequency of self-monitoring and of severe hypoglycemia (49 and 5%) paralleled the relative weight of type1 DM patients during standardization. CONCLUSION - It is concluded that centralized evaluation and anonymous comparison of crude and adjusted data might be helpful in assessing and improving the quality of diabetes care. ]

AFFILIATIONS

  1. Semmelweis Egyetem I. Belgyógyászati Klinika, Diabétesz Gondozási Nemzeti Központ
  2. Szent Imre Kórház II. Belgyógyászati Osztály Diabétesz Részleg, Diabétesz Gondozási Nemzeti Központ, Budapest

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