Overall quality of diabetes care in a defined geographic region:different sides of the same story

BackgroundIn diabetes care, knowledge about what is achievable in primary and secondary care is important. There is a need for an objective method to assess the quality of care in different settings. A quality-of-care summary score has been developed based on process and outcome measures. An adapted version of this score was used to evaluate diabetes management in different settings.AimTo evaluate the quality of diabetes management in primary and secondary care in a defined geographic region in the Netherlands, using a quality score.Design of studyCross-sectional study.SettingThirty general practices in the Netherlands.MethodA study of 2042 patients with type 2 diabetes (1640 primary care and 402 secondary care) was conducted. Quality of diabetes management was assessed by a score of process and outcome indicators (range 0-40). Clustering at practice level and differences in patient characteristics (case mix) were taken into account.ResultsAt the outpatient clinic, patients were younger (mean age 64.1 years, standard deviation (SD) = 12.5 years, versus mean age 67.1 years, SD = 11.7, PConclusionGPs and internists are treating different categories of patients with type 2 diabetes. However, overall quality of diabetes management in primary and secondary care is. equal. There is much room for improvement. Future guidelines may differentiate between different categories of patients.