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Conference Abstracts

A data framework to assess quality of integrated diabetes care in Belgium

Authors:

Veerle Buffel ,

University Of Antwerp, Belgium, BE
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Katrien Danhieux,

University Of Antwerp, Belgium, BE
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Philippe Bos,

University Of Antwerp, Belgium, BE
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Roy Remmen,

University Of Antwerp, Belgium, BE
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Josefien van Olmen,

University Of Antwerp, Belgium, BE
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Edwin Wouters

University Of Antwerp, Belgium, BE
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Abstract

Introduction: Assessing the quality of integrated care of diabetes type 2 (T2D) and investigating differences in this quality between patient groups and different types of primary care practices are highly relevant. T2D care is relatively straightforward from a technical point of view, but it is socially and organizationally complex. We should be able to follow the patient throughout the care path, monitor their care process and link them to their health outcomes, while simultaneously link this information to the primary care system and its performance on the structure and organization related quality indicators. However the development process of such a data framework remain challenging, even in a period of increasing and improving health data storage and management. 

Aims and Methods:  To assess the quality of integrated T2D care, this study aims to develop an integrated data framework and to operationalize this framework in the fragmented Belgium healthcare and data landscape. Based on document review and iterative working group sessions, theoretical approaches and quality indicators were identified and assessed. After mapping and assessing the validity of existing health information systems and available data sources through expert consultations, the theoretical framework was translated in a data framework with measurable quality indicators. The construction of the database included sampling procedures, data-collection, and several technical and privacy-related aspects of linking and accessing Belgian datasets.

Results: To address the three dimensions of quality of care from the Donabedian’s model, we integrated the chronic care model (CCM) and cascade of care (CoC) approach, addressing respectively the structure related quality indicators and the process and outcome related indicators. The CCM is the golden standard for the organization and structuring of chronic care at the primary care level and the CoC approach maps the entire chronic care trajectory from screening to being under control. Structure related quality data is self-collected at the primary care practice level (using the Assessment of quality of integrated care ‘ACIC’ tool) and health insurance data is linked to lab data at the patient level for the process and outcome related quality information.

Conclusions: This study describes the transition of a theoretical quality of care framework to a unique multilevel database, which allows assessing the quality of T2D care, by considering the complete care continuum (process and outcomes) as well as organizational characteristics of primary care practices. 

Implications: The phased approach of the development of a theoretical framework of quality of care, and its translation in a data framework with measurable quality indicators can be used as a template for the quality assessment of integrated T2D care in other countries with a complex data landscape and for other chronic diseases.
How to Cite: Buffel V, Danhieux K, Bos P, Remmen R, van Olmen J, Wouters E. A data framework to assess quality of integrated diabetes care in Belgium. International Journal of Integrated Care. 2022;22(S3):285. DOI: http://doi.org/10.5334/ijic.ICIC22144
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Published on 04 Nov 2022.

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