With diabetes reaching epidemic proportions, prevention of complications by effective diabetes management is essential. Quality indicators enable comparisons between care provided by healthcare providers (HCPs) and predefined standards of care. Different national clinical diabetes registries include different sets of quality indicators. In 2017 the BIDON foundation initiated the Dutch Pediatric and Adult Registry of Diabetes (DPARD), with the goal of acquiring an insight into the characteristics of the Dutch diabetes outpatient population. Diabeter is one of the participating centers in DPARD. The publication described here, co-authored by Theo Sas of Diabeter, aimed to present quality indicators used in the Netherlands, using DPARD, and compare them with other registries worldwide. As previously found, inconsistencies between registries were expected.

Indicators in the national DPARD data were compared with indicators on a global level, proposed by the Organisation for Economic Cooperation and Development (OECD) and the International Consortium for Health Outcomes Measurement (ICHOM), the Centers for Disease Control and Prevention (CDC), and the European Core Indicators in Diabetes (EUCID). Quality indicators were categorized as:

• structure indicators (information about healthcare organization)
• process indicators (insight into healthcare processes)
• outcome indicators (outcomes in the short or long term)

Key findings:

• 22,692 people with diabetes (PWDs) included in DPARD, 3,738 visited diabetes outpatient clinics of 6 medical centers (8% of all Dutch general hospitals, expecting to rise in the next years)
• Adults: 56 years old; 53% male; 48% T1D; BMI 28 kg/m²; HbA1c 175 mmol/mol
• Children: 13 years old; 52% male; 94% T1D; BMI 20 kg/m²; HbA1c 183 mmol/ml
• 10 quality indicators are recorded in DPARD (5 treatment volume indicators, 5 indicators on diagnostics and HbA1c)
• 8 other national registries globally have reported quality indicators
• Despite much variation, all propose eye examination, HbA1c measurement, lipid control, mortality and lower extremity amputation rates
• HbA1c is most frequently recorded, using similar cut-off points
• Only DPARD reports treatment volume indicators
• Robust endpoints (complications, cardiovascular comorbidity, and mortality) are not often reported
• None of the registries include intermediate outcomes (control of blood pressure, HbA1c, and cholesterol)

Concluding, the authors state

Please click here for the PubMed link.