Quality of Care for People with Diabetes

Submission Date: December 2013

State/Territory Submitted on the Behalf of: Wisconsin

States/Territories Involved: Wisconsin

Domain Addressed:

Health Systems Strategies

Public Health Issue:

• People with diabetes are at increased risk of complications such as blindness and heart disease.
• Many complications can be prevented or delayed by optimizing blood sugar control and delivering recommended diabetes care.
• Quality improvement collaboratives help providers in health systems learn better ways to deliver recommended services and monitor outcomes to benefit people with diabetes.

Program Action:

• The Wisconsin Collaborative Diabetes Quality Improvement Project is a collaborative effort involving the Wisconsin Diabetes Prevention and Control Program, Division of Health Care Financing, Wisconsin Diabetes Advisory Group, University of Wisconsin Population Health Institute (UW-PHI), and many Wisconsin HMOs and health systems to evaluate implementation of the Wisconsin Diabetes Mellitus Essential Care Guidelines; improve diabetes care through collaborative quality improvement initiatives; and share resources, strategies, and best practices.
• Progress is tracked using diabetes measures in the Health Plan Employer Data and Information Set (HEDIS) developed by the National Committee for Quality Assurance.
• UW-PHI provides confidential data analysis and reporting and HMOs and health systems meet quarterly to share strategies on improving diabetes care collectively through statewide initiatives and within their own settings.

Impact/Accomplishments:

• Performance by HMOs and health systems on comprehensive diabetes care measures has improved since the project began:
  • LDL cholesterol screening improved by 16%
  • Nephropathy monitoring improved by 41%
  • Eye exams increased by 10%
• Health outcomes also improved:
  • LDL cholesterol control improved by 8% (control is defined as < 130mg/dL)
  • Poorly controlled HbA1c decreased by 9% (HbA1c is an indicator of blood sugar control; a level >9.0% is an indicator of poor blood sugar control)
• The project served as a model of dissemination and research for UW-PHI as in the following examples :
  • Remington P, Chudy N.  The Wisconsin Diabetes Control Program:  A Health Systems and Community-based Approach.  WPHA Communique 1995;32(1):1-2.
  • Remington PL, Chudy N, Conway T, Wood S.  The Wisconsin Diabetes Control Program:  A Health Systems and Community-based Approach.  Wis Med J. 1995;94(4):209-12.
  • Siomos EE. Newsom RS. Camponeschi J. Remington PL. A Statewide Collaboration to Monitor Diabetes Quality Improvement among Wisconsin Health Plans. Am J Manag Care. 2005;11(5):332-6.

Program Areas:

Diabetes

State Contact Information:

WI
Mark Wegner, MD, MPH
Wisconsin Department of Health Services, Division of Public Health
608-267-3835
mvwegner@wisc.edu

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