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Measuring the Quality of Diabetes Care

In 1995, the National Committee for Quality Assurance began the process of developing quality performance measures for diabetes care, which have become more sophisticated with time. Diabetes was one of the first conditions for which quality measures were developed because many disease-related factors can be quantified. Impact of Diabetes Quality Measures In the July 2011 issue of Diabetes Care, my colleagues and I published a consensus statement sponsored by the American Diabetes Association on the importance of diabetes quality measures. In our analysis, we found that diabetes care has improved dramatically since 1995. For example, the median national A1C goal was 8.6% in 1995, but it is now around 7.0%. Median systolic blood pressure and LDL cholesterol measurements have also dropped substantially. Physicians, most notably primary care physicians but also diabetes educators and endocrinologists, should be largely credited for these improvements because they have changed their approaches to managing the disease. It’s clear that quality measures for diabetes are here to stay and have contributed to at least some of the momentum toward improved care in recent years. Quality measures for diabetes are here to stay and have contributed to at least some of the momentum toward improved care in recent years. The potential unintended consequences of diabetes quality measures are a cause of concern. Standards of care proposed by the American Diabetes Association indicate that an A1C of less than 7.0% is appropriate for some patients while 8.0% is appropriate for others. The simplest solution would be to set the A1C target at less than 8.0% for quality measures, giving providers flexibility to tailor A1C goals based on...
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