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

研究成果: Article査読

7 被引用数 (Scopus)

抄録

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.

本文言語English
論文番号107750
ジャーナルDiabetes Research and Clinical Practice
155
DOI
出版ステータスPublished - 2019 9

ASJC Scopus subject areas

  • 内科学
  • 内分泌学、糖尿病および代謝内科学
  • 内分泌学

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