Understanding the quality of diabetes care in Japan: a systematic review of the literature

Abstract

Background Among chronic diseases, diabetes is a frequent focus of performance measurement. Disease-specific indicators based on evidence-based clinical guidelines have been used to evaluate the quality of care. There are worldwide efforts to improve the quality of diabetes care. Measuring the gap is an essential first step toward improving the quality of care. Methods In order to better understand the status of quality of diabetes care in Japan, a country with a universal healthcare system, we performed a literature search looking for all studies reporting on quality indicators. In this review, we summarized the studies that have looked at the status of the quality of diabetes care over the last decade. Results There were a total of 6 studies that reported on process including HbA1c, blood pressure, lipid screening, retinopathy and nephropathy screening and intermediate clinical measures which included percentages of patients reaching targets for HbA1c, blood pressure and LDL-C. Overall, the process measures continue to improve, however the clinical intermediate outcome measures remain suboptimal. Conclusion Despite the improvement in diabetes related process measures, there is limited data on clinical measures. It is necessary to shed more light on the assessment of the quality of diabetes care.

Status of screening and preventive efforts against diabetic kidney disease between 2013 and 2018: analysis using an administrative database from Kyoto-city, Japan

“…This study showed low implementation rates for quantitative urine albumin and protein testing as DKD screening, which are recommended in the guidelines ( 7 , 8 ). Although urine screening testing is recommended every 3 to 6 months and is covered by health insurance in Japan, the actual frequency of testing is lower than recommended ( 23 , 25 , 26 ). The actual frequency of urine screening testing in Japan is lower than that in other developed countries ( 27 ).…”

Efficacy of Self-Review of Lifestyle Behaviors with Once-Weekly Glycated Albumin Measurement in People with Type 2 Diabetes: A Randomized Pilot Study

“…Patients with type 2 diabetes in Japan visit the hospital once every month or every few months to measurement of the HbA1c level [ 12 , 13 ]. More frequent testing of HbA1c has been reported as not being effective in improving the glycemia status [ 14 ] because of the relatively long half-life of hemoglobin.…”