ABSTRACT
Because of the huge financial and health care burden of diabetes in the United States and worldwide, standards of care for persons with diabetes has become an extremely important topic. For several years the American Diabetes Association (ADA) has published Clinical Practice Recommendations. The issue of standards of care has grown increasingly important over the last number of years as a large body of government regulatory agencies and groups to promote quality health have adopted in large part the ADA's recommendations. Included at this time are the ADA, National Committee for Quality Assurance (NCQA), Health Care Financial Administration (HCFA), and Foundation for Accountability (FACCT). All these associations have come together in a collaborative mode and agreed on a single set of measures (not guidelines). The Diabetes Quality Improvement Project (DQIP) has delineated six measures (Table 1) that reflect key components of diabetes care. As stated by the DQIP committee "the DQIP measures are NOT guidelines for care and do not reflect either the minimal or maximal level of care that should be provided to the individual patient with diabetes. The measures are indicators or tools to assess the level of care provided within systems of care to populations of patients with diabetes." In several instances the DQIP '' measures'' differs from the "standards" described in this chapter. These measures will be used to evaluate health plans as part of the HEDIS (Health and Employer Data and Information Set) system. The measures are indicators or tools that assess the level of care provided within a system of care. In the future, individual physicians may be judged based on the extent to which their care conforms to established guidelines. The Provider Recognition Program which is cosponsored by the ADA and NCQA is a program whereby individual physicians or groups of physicians prospectively evaluate the care of their patients and submit this data to achieve this measure of national recognition.
