Quality of Type II Diabetes Care in Primary Health Care Centers in Kuwait: Employment of a Diabetes Quality Indicator Set (DQIS)

Abstract

Diabetes Mellitus is one of the major public health challenges, affecting more than 347 million adults worldwide. The impact of diabetes necessitates assessing the quality of care received by people with diabetes, especially in countries with a significant diabetes burden such as Kuwait. This paper aimed at piloting an approach for measuring Type II diabetes care performance through the use of a diabetes quality indicator set (DQIS) in primary health care. The DQIS for Kuwait was adapted from that developed by the National Diabetes Quality Improvement Alliance and the International Diabetes Federation. Five key care domains/measures were employed: (1) Blood glucose level measurement, (2) Cholesterol level measurement, (3) Blood pressure measurement, (4) Kidney function testing and (5) Smoking status check. The sample included the four major primary health care centers with the highest case load in Kuwait City, 4,241 patients in 2012 and 3,211 in 2010. Findings revealed the applicability and utility of employing performance indicators for diabetes care in Kuwait. Furthermore, findings revealed that many of the primary health care centers have achieved noteworthy improvement in diabetes care between 2010 and 2012, with the exception of smoking status check. The DQIS can help policymakers identify performance gaps and investigate key system roadblocks related to diabetes care in Kuwait.

Fig 1. Key facts and figures on Diabetes in Kuwait.

Data compiled from various sources: (i) The Impact of Main Chronic Conditions in Kuwait—Diabetes, Dasman Diabetes Institute; (ii) Musaiger, 2011, Overweight and Obesity in Eastern Mediterranean Region: Prevalence and Possible Causes, Journal of Obesity; (iii) International Diabetes Federation Diabetes Atlas 5th Edition.

Fig 2. Trend of indicators fluctuation between 2010 and 2012.

Fig 3. Control measures: Glycosylated Hemoglobin (HbA1c), Low-Density Lipoprotein (LDL) cholesterol, and blood pressure (2012)—comparison of PHC centers.

The baseline of diabetic patients for benchmarks was set at 100 as a reference.

Fig 4. Control measures: Glycosylated Hemoglobin (HbA1c), Low-Density Lipoprotein (LDL) cholesterol, and blood pressure (2012)—comparison of overall measures.