Diabetes Outcome Indicators
Diabetes outcome indicators have been developed and utilized to measure progress on the issue. The development and use of these indicators is attributable the increased prevalence of this condition worldwide, which in turn places huge burdens on healthcare systems. Consequently, diabetes management has become a major issue in the public health sector. According to O’Connor et al. (2011), diabetes outcome indicators relating to care include control of blood pressure, hemoglobin A1C, and LDL cholesterol. These outcome indicators were among the initial Diabetes Quality Improvement Program (DQIP) measures and have been included in subsequent sets of diabetes quality measurements.
These outcome indicators have been developed and are utilized because they are risk factors that predict clinical outcomes and relates to challenges and complexities associated with diabetes. Systolic blood pressure levels (sBP) are set at <160 mmHg, which is the dichotomous threshold goal for all diabetic patients. In this regard, diabetic patients whose blood pressure levels exceed the threshold require extra pharmacologic or lifestyle intervention. The achievement of this outcome indicator is high because the threshold is high. However, when the threshold is lowered, many diabetic patients are unable to meet it resulting in the need for additional treatment. With regards to control of glycated hemoglobin A1C, many patients are unable to meet the established threshold of A1C <9%.
For example, even though there has been a national decline in this outcome indicator, between 33% and 49% of patients fail to meet the established targets for glycemia (Mitri & Gabbay, 2016). Additionally, the same percentage of patients fail to meet targets for low-density lipoprotein (LDL) cholesterol control. It is estimated that only 14% of diabetics meet the established targets for all the three outcome indicators because of the high threshold across each of the measures. However, the establishment of lower thresholds could make it even more difficult for these patients to meet them. For example, thresholds of A1C <7% and sBP <130 mmHg could actually do more harm to patients than good.
References
Mitri, J. & Gabbay, R.A. (2016, March). Measuring the Quality of Diabetes Care. Retrieved October 2, 2018, from https://www.ajmc.com/journals/evidence-based-diabetes-management/2016/march-2016/measuring-the-quality-of-diabetes-care?p=1 O’Connor et al. (2011, July). Diabetes Performance Measures: Current Status and Future Directions. Diabetes Care, 34(7), 1651-1659. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120200/
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