Abstract
BackgroundInformation on prescribing quality of diabetes care is required by health care providers, insurance companies, policy makers, and the public. Knowledge regarding the opinions and preferences of all involved parties regarding prescribing quality information is important for effective use of prescribing quality indicators.MethodsBetween June and December 2009 we conducted semi structured interviews with 16 key-informants representing eight different organizations in the Netherlands involved in healthcare quality measurement and improvement. The interview guide included topics on participants’ opinions and preferences regarding existing types of prescribing quality indicators in relation to their aim of using quality information. Content analysis methods were used to process the resulting transcripts following the framework of predetermined themes.ResultsFindings from this qualitative study of stakeholder preferences showed that indicators focusing on undertreatment are found important by all participants. Furthermore, health care providers and policy makers valued prescribing safety indicators, insurance companies prioritized indicators focusing on prescribing costs, and patients’ organization representatives valued indicators focusing on interpersonal side of prescribing. Representatives of all stakeholders preferred positive formulation of the indicators to motivate health care providers to participate in health improvement programs. A composite score was found to be most useful by all participants as a starting point of prescribing quality assessment. Lack of information on reasons for deviating from guidelines recommendations appeared to be the most important barrier for using prescribing quality indicators. According to the health care providers, there are many legitimate reasons for not prescribing the recommended treatment and these reasons are not always taken into account by external evaluators. The latter may cause mistrust of health care providers towards external stakeholders and limit the use of PQI in external quality improvement programs.ConclusionPrescribing quality indicators are considered to be an important tool for assessing quality of provided diabetes care by all participants, although the preferences for specific types of indicators may differ by stakeholder depending on their user aim. Introduction of information systems to register the reasons for deviating from the recommended drug treatment may contribute to a more widespread use of PQI for assessment of provided health care quality to diabetic patents. This study identified the potential preferences regarding quality indicators for diabetes care, and this could be used for development of questionnaires to conduct a survey among a larger group of participants.
Highlights
Information on prescribing quality of diabetes care is required by health care providers, insurance companies, policy makers, and the public
We explored whether and why the prescribing quality indicators (PQI) are considered a relevant part of quality assessment of type 2 diabetes mellitus (T2DM) care, and which types of PQI should be included in quality improvement programs for diabetes according to different key representatives
Usage and aims of prescribing quality indicators by the stakeholders All participants with the exception of the representatives of the patient organization used some sort of PQI for T2DM management
Summary
Information on prescribing quality of diabetes care is required by health care providers, insurance companies, policy makers, and the public. Knowledge regarding the opinions and preferences of all involved parties regarding prescribing quality information is important for effective use of prescribing quality indicators. Insight into the quality care is demanded by healthcare providers, payers, and patients. These different stakeholders use quality information for different purposes such as internal quality improvement, cost containment, and accountability. There is general agreement that due to varying aims of using quality information, the different stakeholders have specific preferences for the type of quality information [1,2,3]. We explored the opinions and preferences of different stakeholders regarding prescribing quality indicators in diabetes care. Appropriate drug prescribing has been recognized as an important quality of care issue in the management of chronic conditions, such as type 2 diabetes mellitus (T2DM). Appropriate pharmacological treatment of diabetes and related risk factors helps to reduce complications in patients with T2DM [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
