Diabetes Care Quality Improvement: A Resource Guide for State Action
A Resource Guide for State Action — Supplement
The Agency for Healthcare Research and Quality (AHRQ), as part of its mission to translate research into practice and improve health care quality, develops products to assist State leaders who aim to improve diabetes care in their States. Two of these resources, published in 2004, are:
- Diabetes Care Quality Improvement: A Resource Guide for State Action.
- Diabetes Care Quality Improvement: A Workbook for State Action.
These documents were based on AHRQ's 2003 National Healthcare Quality Report, which established a baseline for measuring health care quality for the Nation overall and at the State level when data are available. The Resource Guide and its companion Workbook are intended to assist State leaders in considering the need for diabetes care improvements and in knowing how to foster change in their States.
This supplement to the Resource Guide includes data on diabetes care from the 2004 National Healthcare Quality Report, which was released in February 2005.
State-Level Diabetes Care Quality Indicators
This supplement presents four quality indicators that describe diabetes care at the State level. These four measures are based on the AHRQ Prevention Quality Indicators, which assess ambulatory care sensitive conditions—hospital admissions that, evidence suggests, could have been avoided, at least in part, through high-quality outpatient care.
These potentially avoidable hospitalizations are outcome indicators for diabetes care in ambulatory settings within the State:
- Hospital admissions for uncontrolled diabetes per 100,000 population.
- Hospital admissions for short-term complications of diabetes per 100,000 population.
- Hospital admissions for long-term complications of diabetes per 100,000 population.
- Hospital admissions for lower extremity amputations in patients with diabetes per 100,000 population.
These quality indicators are derived from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases, a series of State-specific databases that capture all discharge records from hospitals in each State. These data are produced by a Federal-State-Industry partnership currently involving 38 States.
The 32 States analyzed in the 2004 quality report (Table 1) comprise 79 percent of community hospital discharges in the United States. The Resource Guide explains how to use the Prevention Quality indicator rates and their standard errors to analyze a State's standing, to create graphics for a State, and to test for differences between a State rate and the best-decile or the national average. Those tests ensure that policymakers will focus on differences that likely reflect health system problems and not on differences that occur because of data weaknesses.
How To Use the Resource Guide
Diabetes Care Quality Improvement: A Resource Guide for State Action provides detailed guidance on how to interpret and evaluate measures and explains the importance of using data and measurement to begin a quality improvement program, to track progress, and to influence continuous improvement.
Key actions to take to make change happen include:
- Sharing information with quality improvement leaders in your State to understand what the data mean, how they might relate to health care practices in your State, and what to do to change behavior that improves the care your citizens receive.
- Examining your State's position across multiple indicators of diabetes care quality; most States are high on some measures and low on others.
- Aiming to move your State into the best-in-class of States (or to the best-decile average) rather than aiming for the national average.
For More Information
The Resource Guide and Workbook are available online at www.ahrq.gov/professionals/quality-patient-safety/quality-resources/diabqual/diabqualoc.html. Printed copies may be requested by calling the AHRQ Publications Clearinghouse at (800) 358-9295 or by Email at AHRQPubs@ahrq.hhs.gov.
AHRQ released another diabetes-related resource in January 2005. HCUP Highlight 1, Economic and Health Costs of Diabetes, reveals that about two-thirds of the $2.5 billion in hospitalization costs that could be saved annually with better diabetes care could accrue to Medicare and Medicaid.
Select for a list of HCUP Partners Who Contributed Data to the 2004 National Healthcare Quality Report.