Diabetes quality of care at a university community in Beirut.

RATIONALE, AIMS AND

OBJECTIVES

To assess the quality of diabetes mellitus (DM) care provided by a group of family doctors in Beirut.

METHODS

An observational study, conducted at the American University of Beirut Medical Center-Family Medicine Clinics (AUBMC-FMC), examined the electronic health records (EHRs) of the beneficiaries of the Health Insurance Plan at the American University of Beirut (AUB-HIP) who were older than 20 years (n = 9469) in 2009. The eligible population included patients with DM (n = 701). Several provider/patient-directed interventions were introduced in the late 2000s, including a comprehensive EHRs system with point-of-care computer reminders, a provider financial incentive based on an annual performance appraisal ranked against that of the US Healthcare Effectiveness Data and Information Set (HEDIS) Comprehensive Diabetes Care indicators, as well as periodic up-to-date training.

RESULTS

Optimal control for HbA1c, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides and blood pressure were found in 58.6%, 51.0%, 22.4%, 53.3% and 60.2% of the population, respectively. 64.1% and 70.0% received screening for diabetic nephropathy and a dilated eye examination, respectively. When benchmarked against the HEDIS Comprehensive Diabetes Care indicators, the AUB-HIP's quality of care was 13% higher than the average of all plans in the United States. Screening for nephropathy, however, did not reach the above benchmark.

CONCLUSIONS

Benchmarking served as an important tool in evaluating the current DM care offered and in detecting gaps, yet interventions are recommended for further improvement.