Relation Between Quality-of-Care Indicators for Diabetes and Patient Outcomes: A Systematic Literature Review

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Abstract

The authors conducted a systematic literature review to assess whether quality indicators for diabetes care are related to patient outcomes. Twenty-four studies were included that formally tested this relationship. Quality indicators focusing on structure or processes of care were included. Descriptive analyses were conducted on the associations found, differentiating for study quality and level of analysis. Structure indicators were mostly tested in studies with weak designs, showing no associations with surrogate outcomes or mixed results. Process indicators focusing on intensification of drug treatment were significantly associated with better surrogate outcomes in three high-quality studies. Process indicators measuring numbers of tests or visits conducted showed mostly negative results in four high-quality studies on surrogate and hard outcomes. Studies performed on different levels of analysis and studies of lower quality gave similar results. For many widely used quality indicators, there is insufficient evidence that they are predictive of better patient outcomes.

Original languageEnglish
Pages (from-to)263-289
Number of pages27
JournalMedical Care Research and Review
Volume68
Issue number3
DOIs
Publication statusPublished - Jun-2011

Keywords

  • health care quality
  • quality of care
  • quality indicators
  • outcome
  • assessment
  • diabetes mellitus
  • CLINICAL INERTIA
  • AMBULATORY-CARE
  • MICROVASCULAR COMPLICATIONS
  • HEALTH-CARE
  • RISK
  • ASSOCIATION
  • IMPROVEMENT
  • MELLITUS
  • METAANALYSIS
  • MANAGEMENT

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