Abstract

Purpose: We held a conference with the following objectives:

1. Bring together scientific and clinical experts in the field of diabetes and quality measurement.
2. Review the state of the art in diabetes epidemiology and quality measurement science.
3. Plan essential research for improving technical and interpersonal quality measurement.
4. Provide recommendations regarding new measures of technical and interpersonal quality.
5. Disseminate conference conclusions.

Scope: Over the past 5-10 years, there have been substantial improvements in the processes of diabetes medical care (e.g., checking laboratory tests at indicated intervals) but less dramatic improvements in risk factor control (e.g., value of blood pressure, glycemic, or lipid control). Further, although quality measurement in diabetes has advanced beyond that of other conditions, several challenges remain in developing effective quality measures. These include constructing measures designed to improve risk factor control without causing unintended consequences and implementing patient assessments of quality.

Methods: Therefore, the Michigan Diabetes Research & Training Center's (MDRTC) Measurement Core, the Department of Veterans Affairs (VA) Quality Enhancement Research Initiative for Diabetes (QUERI-DM), and the Center for Health Policy Research organized a national multidisciplinary conference on diabetes quality measurement. The conference was held May 24-25, 2006, in Ann Arbor, MI. The conference brought together 40 key investigators and stakeholders to discuss and plan issues surrounding diabetes technical and interpersonal quality measurement.

Results: Following a lively discussion, participants suggested a series of general principles and areas for future research. Recommendations included that performance measures should:

1. Be constructed so that the credit for achieving the measure is commensurate with the likelihood of benefit to the patient
2. Be constructed to motivate improvements in quality while minimizing problems with patient safety and unintended consequences.
3. Be improved through the use of clinically detailed data, and the limitations of measures that use only utilization data should be disclosed.
4. Incorporate patient assessments of quality.

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