A POPULATION-BASED QUALITY ASSURANCE PROJECT IN 2 SWEDISH COUNTIES - EXPERIENCE WITH THE DIABCARE BASIC INFORMATION SHEET

The Swedish national implementation programme for the St. Vincent Decl aration has evaluated the structure and process of diabetes management for a total population of 1 million inhabitants. In order to go furth er and evaluate also outcome data the DIABCARE Basic Informtion Sheet was applied to all diabetic patients who sought medical care during on e week in March, 1993 in the counties of Uppsala and Gotland. The tota l population of 331,000 is served by 7 hospital-based clinics (1 unive rsity hospital with a catchment area of 220,000) and 39 health care ce ntres with general practitioners and 7 private practitioners. Altogeth er 506 sheets were completed (97 were insulin-dependent patients). Twe nty percent of the patients were treated with insulin, 70% with oral h ypoglycaemic drugs and 20% with diet only. Ninety percent of the IDDM patients and 31% of the NIDDM patients with insulin took greater-than- or-equal-to 3 doses of insulin/day. Fundus photography had been perfor med during the last year in 87% of IDS and 55% of patients. The assess ment of serum lipids and microalbuminuria screening was insufficient, whereas haemoglobulin Alc was assessed regularly in all patients with IDDM and in 70% of NIDDM patients. Metabolic control was better for pa tients with IDDM than for NIDDM, when it was related to goals for trea tment. The DIABCARE Basic Information Sheet was found to be well suite d for use in quality assurance projects and is an adequate instrument for the evaluation of outcome data in diabetes management.