Realistic possibilities of using data sources in quality assessment of care of patients with diabetes in the Czech Republic: National Diabetes Information System

Česká verzia

Authors: Milan Kvapil
Authors place of work: Interní klinika 2. LF a FN Motol, Praha, přednosta prof. MUDr. Milan Kvapil, CSc., MBA
Published in the journal: Vnitř Lék 2015; 61(Suppl 3): 10-13
Category: Reviews

Summary

Diabetes mellitus is a serious health and economic problem of our time. Therapy is primarily perceived as prevention of the late complications of diabetes. Most pharmacoeconomic analyses state that the cost associated with the therapy of diabetes mellitus is largely spent on the therapy of its complications. The project of the National Diabetes Information System is based on the essential principle of automated collection of data which is available in digital form in the Czech Republic and which describes the quality and quantity of the care provided for patients with diabetes mellitus and its results. Benefits of the posited National Diabetes Information System embrace minimizing of selective loss of data, a comprehensive view of epidemiology, therapy and its results, possibility of following trends, inclusion of costs related to hospitalization and social benefits. Risks involve correct interpretation and a possible system error. If we succeeded in implementing such system in the Czech Republic, it would be the first fully automatic information system on such a comprehensive scale worldwide.

Conclusion:
The data describing the incidence and prevalence of diabetes mellitus, therapy structure, direct healthcare costs and induced costs of social payments is in the largest part available in digital form. This creates a basis for the foundation of the National Diabetes Information System which will allow for continuous quality assessment of care for patients with diabetes mellitus, including the related pharmacoeconomic and social impacts.

Key words:
data sources – diabetes mellitus – pharmacoeconomics – information system – complications of diabetes mellitus – register

Zdroje

1. Bartášková D, Kožnarová R, Kvapil M. Analýza farmakoekonomických aspektů léčby diabetes mellitus v České republice. Remedia 2004; 14(4): 377–384.

2. Doležal T, Písaríková Z, Zemanová P et al. Náklady na diabetes 2. typu v podmínkách zdravotního systému České republiky. Vnitr Lek 2009; 55(4): 342–344.

3. Klazinga N. Patient Safety and Quality of Care Working Group, Brussels, March 13 2014. Update on OECD’s Health Care Quality Indicator Project Measurement, Information Systems, Policies and Governance in OECD countries. Dostupné z WWW: <http://ec.europa.eu/health/patient_safety/docs/ev_20140313_rd03_en.pdf>.

4. Greenfield S, Nicolucci A, Mattke S. Selecting Indicators for the Quality of Diabetes Care at the Health Systems Level in OECD Countries. DELSA/ELSA/WD/HTP(2004)15. Dostupné z WWW: <http://www.oecd.org/els/healthsystems/33865546.pdf>.

5. Travaglia J, Debono D. Clinical indicators: a comprehensive review of the literature. Centre for Clinical Governance Research in Health. Faculty of Medicine – University of New South Wales Sydney. NSW 2052. 2009. Dostupné z WWW: <http://www.health.vic.gov.au/clinicalengagement/downloads/pasp/literature_review_clinical_indicators.pdf>.

6. OECD Health Indicators at a Glance. OECD: 2009. Dostupné z WWW: <http://www.slideshare.net/dalesanders1/oecdhealthindicatorsataglance>.

7. PeytremannBridevaux I, Bordet J, Burnand B. Diabetes care in Switzerland: good, but perfectible: a populationbased crosssectional survey. BMC Health Serv Res 2013; 13: 232. Dostupné z DOI: <http://dx.doi.org/10.1186/1472–6963–13–232>.

8. Ali MK, Bullard KM, Saaddine JB et al. Achievement of goals in U.S. diabetes care, 1999–2010. N Engl J Med 2013; 368(17): 1613–1624.

9. Wollersheim H, Hermens R, Hulscher M et al. Clinical indicators: development and applications. Neth J Med 2007; 65(1): 15–22.

10. de Wit M, Delemarrevan de Waal HA, Pouwer F et al. Monitoring health related quality of life in adolescents with diabetes: a review of measures. Arch Dis Child 2007; 92(5): 434–439.

11. Guthrie B, Inkster M, Fahey T. Tackling therapeutic inertia: role of treatment data in quality indicators. BMJ 2007; 335(7619): 542–544.

12. Kupersmith J, Francis J, Kerr E et al. Advancing evidencebased care for diabetes: lessons from the Veterans Health Administration. Health Aff (Millwood) 2007; 26(2): w156–68.

13. Rossi MC, Lucisano G, Comaschi M et al. AMDQUASAR Study Group. Quality of diabetes care predicts the development of cardiovascular events: results of the AMDQUASAR study. Diabetes Care 2011; 34(2): 347–352.

14. Kelly PJ, Clarke PM, Hayes AJ et al. Predicting mortality in people with Type 2 diabetes mellitus after major complications: a study using Swedish National Diabetes Register data. Diabet Med 2014; 31(8): 954–962.

15. Asch SM, McGlynn EA, Hogan MM et al. Comparison of quality of care for patients in the Veterans Health Administration and patients in a national sample. Ann Intern Med 2004; 141(12): 938–945.

16. Gudbjörnsdottir S, Cederholm J, Nilsson PM et al. Steering Committee of the Swedish National Diabetes Register. The National Diabetes Register in Sweden: an implementation of the St. Vincent Declaration for Quality Improvement in Diabetes Care. Diabetes Care 2003; 26(4):1270–1276.

17. Eriksson M, Zethelius B, EegOlofsson K et al. Blood lipids in 75,048 type 2 diabetic patients: a populationbased survey from the Swedish National diabetes register. Eur J Cardiovasc Prev Rehabil 2011; 18(1): 97–105.

18. Carstensen B, Kristensen JK, Ottosen P et al. Steering Group of the National Diabetes Register. The Danish National Diabetes Register: trends in incidence, prevalence and mortality. Diabetologia 2008; 51(12): 2187–2196.