Variation in process quality measures of diabetes care by region and institution in Japan during 2015–2016: An observational study of nationwide claims data

Takehiro Sugiyama, Kenjiro Imai, Noriko Ihana-Sugiyama, Hirokazu Tanaka, Ayako Yanagisawa-Sugita, Takayoshi Sasako, Takahiro Higashi, Tomonori Okamura, Toshimasa Yamauchi, Kohjiro Ueki, Mitsuru Ohsugi, Takashi Kadowaki

Research output: Contribution to journalArticle

Abstract

Aims: To calculate process quality measures of diabetes care in Japan using nationwide exclusive claims database. Methods: Using the National Database of health insurance claims during 2015–2016, the proportions of outpatients who received recommended examinations at least annually among those with regular antidiabetic medication were calculated as quality indicators, reported altogether and by prefecture and institutional certification (from the Japan Diabetes Society). Distributions of institutional-level quality indicators were also reported. Results: Among 4,154,452 outpatients, 96.7% underwent HbA1c or glycated albumin examination. Retinopathy examination was conducted among 46.5% of patients [prefecture (range): 37.5%–51.0%, institutional certification: 44.8% (without) vs. 59.8% (with)]. Urinary qualitative examination was conducted among 67.3% of patients at institutions with <200 beds (prefecture: 54.1%–81.9%, institutional certification: 66.8% vs. 92.8%), whereas urinary quantitative albumin or protein examination was conducted among 19.4% of patients (prefecture: 10.8%–31.6%, institutional certification: 18.7% vs. 54.8%). Distributions of institutional-level quality indicators showed that most institutions without institutional certification seldomly order urinary quantitative examination. Conclusions: Although the quality indicator for glycaemic control examination was favourable, some aspects of diabetes care were suboptimal and varied greatly by prefecture and institution; individual and organisational efforts to improve quality of diabetes care would be needed in Japan.

Original languageEnglish
Article number107750
JournalDiabetes Research and Clinical Practice
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Process Assessment (Health Care)
Certification
Observational Studies
Japan
Outpatients
Databases
Quality of Health Care
National Health Programs
Hypoglycemic Agents
Albumins
Proteins

Keywords

  • Claims data
  • Diabetes
  • Health services research
  • Japan
  • Quality of care

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Variation in process quality measures of diabetes care by region and institution in Japan during 2015–2016 : An observational study of nationwide claims data. / Sugiyama, Takehiro; Imai, Kenjiro; Ihana-Sugiyama, Noriko; Tanaka, Hirokazu; Yanagisawa-Sugita, Ayako; Sasako, Takayoshi; Higashi, Takahiro; Okamura, Tomonori; Yamauchi, Toshimasa; Ueki, Kohjiro; Ohsugi, Mitsuru; Kadowaki, Takashi.

In: Diabetes Research and Clinical Practice, 01.01.2019.

Research output: Contribution to journalArticle

Sugiyama, Takehiro ; Imai, Kenjiro ; Ihana-Sugiyama, Noriko ; Tanaka, Hirokazu ; Yanagisawa-Sugita, Ayako ; Sasako, Takayoshi ; Higashi, Takahiro ; Okamura, Tomonori ; Yamauchi, Toshimasa ; Ueki, Kohjiro ; Ohsugi, Mitsuru ; Kadowaki, Takashi. / Variation in process quality measures of diabetes care by region and institution in Japan during 2015–2016 : An observational study of nationwide claims data. In: Diabetes Research and Clinical Practice. 2019.
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abstract = "Aims: To calculate process quality measures of diabetes care in Japan using nationwide exclusive claims database. Methods: Using the National Database of health insurance claims during 2015–2016, the proportions of outpatients who received recommended examinations at least annually among those with regular antidiabetic medication were calculated as quality indicators, reported altogether and by prefecture and institutional certification (from the Japan Diabetes Society). Distributions of institutional-level quality indicators were also reported. Results: Among 4,154,452 outpatients, 96.7{\%} underwent HbA1c or glycated albumin examination. Retinopathy examination was conducted among 46.5{\%} of patients [prefecture (range): 37.5{\%}–51.0{\%}, institutional certification: 44.8{\%} (without) vs. 59.8{\%} (with)]. Urinary qualitative examination was conducted among 67.3{\%} of patients at institutions with <200 beds (prefecture: 54.1{\%}–81.9{\%}, institutional certification: 66.8{\%} vs. 92.8{\%}), whereas urinary quantitative albumin or protein examination was conducted among 19.4{\%} of patients (prefecture: 10.8{\%}–31.6{\%}, institutional certification: 18.7{\%} vs. 54.8{\%}). Distributions of institutional-level quality indicators showed that most institutions without institutional certification seldomly order urinary quantitative examination. Conclusions: Although the quality indicator for glycaemic control examination was favourable, some aspects of diabetes care were suboptimal and varied greatly by prefecture and institution; individual and organisational efforts to improve quality of diabetes care would be needed in Japan.",
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T1 - Variation in process quality measures of diabetes care by region and institution in Japan during 2015–2016

T2 - An observational study of nationwide claims data

AU - Sugiyama, Takehiro

AU - Imai, Kenjiro

AU - Ihana-Sugiyama, Noriko

AU - Tanaka, Hirokazu

AU - Yanagisawa-Sugita, Ayako

AU - Sasako, Takayoshi

AU - Higashi, Takahiro

AU - Okamura, Tomonori

AU - Yamauchi, Toshimasa

AU - Ueki, Kohjiro

AU - Ohsugi, Mitsuru

AU - Kadowaki, Takashi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aims: To calculate process quality measures of diabetes care in Japan using nationwide exclusive claims database. Methods: Using the National Database of health insurance claims during 2015–2016, the proportions of outpatients who received recommended examinations at least annually among those with regular antidiabetic medication were calculated as quality indicators, reported altogether and by prefecture and institutional certification (from the Japan Diabetes Society). Distributions of institutional-level quality indicators were also reported. Results: Among 4,154,452 outpatients, 96.7% underwent HbA1c or glycated albumin examination. Retinopathy examination was conducted among 46.5% of patients [prefecture (range): 37.5%–51.0%, institutional certification: 44.8% (without) vs. 59.8% (with)]. Urinary qualitative examination was conducted among 67.3% of patients at institutions with <200 beds (prefecture: 54.1%–81.9%, institutional certification: 66.8% vs. 92.8%), whereas urinary quantitative albumin or protein examination was conducted among 19.4% of patients (prefecture: 10.8%–31.6%, institutional certification: 18.7% vs. 54.8%). Distributions of institutional-level quality indicators showed that most institutions without institutional certification seldomly order urinary quantitative examination. Conclusions: Although the quality indicator for glycaemic control examination was favourable, some aspects of diabetes care were suboptimal and varied greatly by prefecture and institution; individual and organisational efforts to improve quality of diabetes care would be needed in Japan.

AB - Aims: To calculate process quality measures of diabetes care in Japan using nationwide exclusive claims database. Methods: Using the National Database of health insurance claims during 2015–2016, the proportions of outpatients who received recommended examinations at least annually among those with regular antidiabetic medication were calculated as quality indicators, reported altogether and by prefecture and institutional certification (from the Japan Diabetes Society). Distributions of institutional-level quality indicators were also reported. Results: Among 4,154,452 outpatients, 96.7% underwent HbA1c or glycated albumin examination. Retinopathy examination was conducted among 46.5% of patients [prefecture (range): 37.5%–51.0%, institutional certification: 44.8% (without) vs. 59.8% (with)]. Urinary qualitative examination was conducted among 67.3% of patients at institutions with <200 beds (prefecture: 54.1%–81.9%, institutional certification: 66.8% vs. 92.8%), whereas urinary quantitative albumin or protein examination was conducted among 19.4% of patients (prefecture: 10.8%–31.6%, institutional certification: 18.7% vs. 54.8%). Distributions of institutional-level quality indicators showed that most institutions without institutional certification seldomly order urinary quantitative examination. Conclusions: Although the quality indicator for glycaemic control examination was favourable, some aspects of diabetes care were suboptimal and varied greatly by prefecture and institution; individual and organisational efforts to improve quality of diabetes care would be needed in Japan.

KW - Claims data

KW - Diabetes

KW - Health services research

KW - Japan

KW - Quality of care

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