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The Wisconsin Collaborative Diabetes Quality Improvement Project.

INTRODUCTION
Performance measurement is an important tool for improving the quality of diabetes care. In this report we describe the Wisconsin Collaborative Diabetes Quality Improvement Project, designed to assess the quality of diabetes care among 18 health care organizations in the state.


METHODS
Fifteen health maintenance organizations, a tribal council, a health care provider, and an insurance corporation participated in the project. Each health care organization reported the percent of their diabetes population who had received selected measures of diabetes preventive care during the reporting year, using HEDIS performance indicators.


RESULTS
The proportion of the population with diabetes receiving preventive care varied by indicator: retinal eye exam (ages > 31 years: 55%; ages 18-75 years: 48%), annual lipid profile (58%); hemoglobin A1c (81%); and nephropathy screening (27%). Rates also varied among health maintenance organizations for each indicator, with rates varying three-fold between organizations for the retinal eye exam indicator (ages > 31 years).


CONCLUSIONS
These data demonstrate considerable variability in the delivery of preventive services to this population with diabetes. The collaborative group involved in this project is currently exploring further collaborative quality improvement opportunities.