Критерии качества помощи при диабете

dok_zlo — 06.05.2025












Quality Indicators for Diabetes in Adults: A Review of Performance Measures by the American College of PhysiciansFREE

Abstract
Type 1 and type 2 diabetes are prevalent chronic illnesses, are leading causes of mortality and morbidity, and result in substantial public health burden. Timely identification and appropriate management of diabetes can help reduce adverse consequences of diabetes. The American College of Physicians (ACP) embraces performance measurement as a means to improve quality of care but believes that a performance measure must be methodologically sound and evidence-based in order to be considered for inclusion in payment, accountability, or reporting programs. These principles are critical given the potential impact on physician administrative work, reputation, and reimbursement and to prevent unintended consequences for patient care. To help improve performance measurement and reduce burden, the ACP Performance Measurement Committee (PMC) reviews performance measures using a rigorous process to recognize high-quality measures and address gaps and areas for improvement. In this article, the PMC presents its review of 14 current performance measures for diabetes that are relevant to internal medicine. The PMC supports kidney health evaluation at the individual and group practice levels, hemoglobin A1c control at the health plan level, eye examination at the health plan level, and angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker therapy at the individual physician level.
The prevalence of diagnosed and undiagnosed diabetes in the United States was estimated at 15.8% (53 million Americans) in 2021 (1). Because diabetes is so prevalent and can significantly affect patient health, multiple performance measures focusing on diabetes screening, diabetes management, and/or management of comorbidities are used in pay-for-performance, public reporting, and/or accountability programs. However, the validity, reliability, quality of evidence, attribution, and meaningfulness of performance measures have been questioned (2). The American College of Physicians (ACP) supports performance measurement as a means to improve quality of care. However, ACP believes performance measures should only be considered for inclusion in reporting, accountability, or payment programs if they are methodologically sound and have undergone appropriate statistical analyses at the level of attribution (for example, physician, group, or health plan) for which they are used. ACP also does not make a recommendation if a measure was not designed or evaluated for attribution at a given level. The ACP Performance Measurement Committee’s (PMC) level of support does not indicate whether or not the intervention is beneficial; rather, the level of support reflects whether the performance measure is scientifically sound and an accurate indication of the quality of care provided. These principles are critical given the potential impact on physician administrative work, reputation, and reimbursement and to prevent unintended consequences for patient care. The purpose of this article is to present a review of current performance measures for diabetes to inform physicians, payers, and policymakers in their selection and use of performance measures. Читать полностью....

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