Understanding and measuring quality of diabetes care

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A new study aiming to develop and test measures of the quality of care for people with type 2 diabetes is starting based in the Tayside Centre for General Practice. The measurement of 'quality' and 'performance' are increasingly common in the NHS, but attract considerable controversy. Debate about quality measurement focuses on three issues:

  1. Is what is being measured the most or only important aspect of care?
  2. How should measures be used (eg confidentially for quality improvement within the NHS, or publicly to promote patient choice and influence)
  3. Are the measures technically valid, and do they reliably distinguish 'better' from 'worse' performance?

This study aims to address these issues and develop a range of valid measures of the quality of diabetes care which are relevant and useful to a range of audiences. To achieve the first two aims, the perspectives of primary and secondary care doctors and nurses, allied health professions, managers, public health and health board professionals and patients will be explored in focus groups and individual interviews. The aim is to identify firstly which aspects of care matter to different people, and secondly the uses (if any) to which different groups think data should be put. We aim to start recruiting for this study in the next few months.

The second part of the study will develop measures to address the various aspects of care identified as important, and examine ways of usefully presenting data to various audiences. An important part of this will be developing measures that take advantage of the high quality longitudinal clinical data available in Tayside, and examine their utility compared to current, simpler (and sometimes simplistic) cross sectional 'snapshots' of quality. All measures will be examined for statistical and technical validity (do they measure what they appear to; can they actually distinguish 'better' and 'worse' care?), and for their relevance and usefulness to different stakeholders from those involved at network or regional level, to individual patients and clinicians.


This project is funded for 3 years by NHS R&D/PPP Foundation/Chief Scientist Office.