Answer
to last weeks question is UK:
According
to a recent study, Which
country provides the best care in preventing complications from diabetes?
- U.K.
- France
- Germany
- Italy
- The
Netherlands
- Sweden
- Switzerland
Answer:
UK
AIMS: To compare the out-patient costs
and process quality of preventing secondary complications in patients with
Type 2 diabetes mellitus in France, Germany, Italy, The Netherlands,
Sweden, Switzerland, and the UK. METHODS: A total of 188 European
physician practices assessed annual services for one hypothetical average
patient (cost evaluation) and 178 practices reported retrospective data on
one or two real patients (quality evaluation) in 2000/2001. In countries
with a detailed fee-for-service schedule (Germany, Italy, and Switzerland)
reimbursement fees were used to approximate costs. These fee-for-service
schedules were also used to develop index (average) fees for all
countries, in order to measure resource utilization. The following process
quality indicators were evaluated: control of HbA1c; control of lipids;
urine test for (micro)albuminuria; control of blood pressure; foot
examination; neurological examination; eye examination; and patient
education. For each country an average quality rating was calculated by
weighting the response to each quality indicator with the level of
scientific evidence.
RESULTS: Average quality ratings ranged
from 0.40 in The Netherlands to 0.62 in the UK (0 = lowest rating; 1 =
highest rating). Total annual costs for secondary prevention were higher
in Switzerland than in Germany and Italy (EUR475, EUR381, and EUR283,
respectively). Resource utilization was highest in Germany and lowest in
the UK.
CONCLUSIONS: The overall quality of
preventive services documented was found to be poor in the seven European
countries studied. The UK rated as both the most effective and the most
efficient country in providing secondary prevention in Type 2 diabetes. Diabet
Med 2002 Jul;19(7):594-601
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