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Selecting Indicators for the Quality of Diabetes Care at the Health Systems Level in OECD Countries

The Issue

Several effective treatments exist for managing diabetes and avoiding complications. Yet there is substantial documented variation in preventive and therapeutic approaches to the disease. As part of the Organization for Economic Cooperation and Development (OECD) Health Care Quality Indicators Project, expert panelists developed a set of quality indicators for diabetes care to compare how national health systems perform in this area.

What the Study Found

Expert panelists reviewed existing quality indicators, particularly those developed as part of the National Diabetes Quality Improvement Alliance in the United States, and discussed their importance, scientific soundness, and feasibility. They selected nine measures: four assessing processes of diabetes care, such as annual HbA1c testing; two assessing intermediate outcomes, such as LDL cholesterol control; and three assessing longer-term outcomes, such as lower-extremity amputation rates. The latter are not currently used to compare performance among providers because of attribution problems. But such measures could reveal useful insights into the differing performances of national health systems.


The diabetes measure set can help policymakers and researchers understand differences in the quality of diabetes care, but further work is needed to assess the comparability and validity of data across OECD countries.

Publication Details



A. Nicolucci, S. Greenfield, and S. Mattke "Selecting Indicators for the Quality of Diabetes Care at the Health Systems Level in OECD Countries," International Journal for Quality in Health Care, Sept. 2006 18(Suppl. 1):26–30.