Köhler S, Use G, Schumann M, Müller U A
Klinik für Innere Medizin II, Friedrich-Schiller-Universität Jena.
Z Arztl Fortbild Qualitatssich. 2000 Jun;94(5):397-405.
Today, effective therapies for patients with diabetes mellitus. However, these therapeutic strategies are often not or incorrectly applied. Following these discrepancies for health care providers, it is mandatory to document the efficacy of diabetes treatment. However, it is hard to prove the outcome of diabetes care because of unsuitable documentation, missing parameters and different definitions of quality indicators. The computer programme DIQUAL was developed to improve the diabetes management on the diabetes ward, the diabetes out-patient department and for the documentation of outcome quality. DIQUAL is a patient database and offers structured data collecting and administration, text processing, referring letters, application and list functions, internal and external quality control, as well as cohort or cross-section analysis, data export function for nation wide data collection, system internal plausibility check and extension modules for scientific studies. On the basis of DIQUAL, the first nation wide comparison of outcome quality in the routine treatment of type 1 diabetes was possible. In 1998, we analysed the original data of 1789 patients from 32 district and university hospitals on the basis of the therapeutic goals. HbA1C decreased 1.8% and the incidence of severe hypoglycaemia was lowered to the half. There was a substantial improvement of processes in the health care institutions and the quality of information transmission to the general practitioners. This system of measurement and improvement of quality is also suitable for other areas in health care and medicine.
如今，有针对糖尿病患者的有效治疗方法。然而，这些治疗策略常常未得到应用或应用不当。鉴于医疗服务提供者存在这些差异，记录糖尿病治疗的疗效是很有必要的。然而，由于记录不恰当、参数缺失以及质量指标的定义不同，很难证明糖尿病护理的结果。开发计算机程序DIQUAL是为了改善糖尿病病房、糖尿病门诊的糖尿病管理以及记录结果质量。DIQUAL是一个患者数据库，提供结构化的数据收集与管理、文本处理、转诊信、应用和列表功能、内部和外部质量控制，以及队列或横断面分析、用于全国数据收集的数据导出功能、系统内部合理性检查和用于科学研究的扩展模块。基于DIQUAL，首次实现了对1型糖尿病常规治疗结果质量的全国性比较。1998年，我们根据治疗目标分析了来自32家地区医院和大学医院的1789例患者的原始数据。糖化血红蛋白（HbA1C）下降了1.8%，严重低血糖的发生率降低了一半。医疗机构的诊疗流程以及向全科医生传递信息的质量有了显著改善。这种质量测量与改进系统也适用于医疗保健和医学的其他领域。
