David H. Jiang, Mayo Clinic, Rochester, Minnesota.
Patrick J. O'Connor, HealthPartners Institute, Minneapolis, Minnesota.
Health Aff (Millwood). 2022 Jul;41(7):955-962. doi: 10.1377/hlthaff.2022.00233. Epub 2022 Jun 27.
The proliferation of diabetes quality measures in the US since the mid-1990s has increased the burden of measurement without commensurate improvements in the quality of care or health outcomes. Measures in use today do not represent or incentivize achievement of care goals in all domains of quality that are necessary to achieve optimal diabetes health. We recommend reimagining and improving diabetes quality measurement through the following propositions: widespread adoption of new measures and modernization of existing measures across six domains of quality; use of a subset of new and modernized metrics as top-line measures for reporting and reimbursement; and optional use of the remaining new and modernized measures for evaluative purposes at all levels of the care delivery system to identify and address gaps in care quality and outcomes. These propositions would support practices and policies at all levels of the health care system to improve the health of people with diabetes.
自 20 世纪 90 年代中期以来，美国糖尿病质量指标的大量涌现增加了衡量的负担，而医疗质量或健康结果并没有相应改善。如今使用的指标并不能代表或激励在实现优质糖尿病健康所需的所有质量领域中实现护理目标。我们建议通过以下建议来重新构想和改进糖尿病质量衡量标准：在六个质量领域中广泛采用新的衡量标准并对现有衡量标准进行现代化改造；将新的和现代化的指标子集用作报告和报销的一线指标；以及在医疗服务提供系统的所有各级别中，根据需要使用其余新的和现代化的指标进行评估，以确定和解决护理质量和结果方面的差距。这些建议将支持医疗保健系统各级别的实践和政策，以改善糖尿病患者的健康。
