Diabetes as a tracer condition in international benchmarking of health systems.

Nolte, E; Bain, C; McKee, M; (2006) Diabetes as a tracer condition in international benchmarking of health systems. Diabetes care, 29 (5). pp. 1007-11. ISSN 0149-5992 DOI: https://doi.org/10.2337/diacare.2951007

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OBJECTIVE: To assess the performance of health systems using diabetes as a tracer condition. RESEARCH DESIGN AND METHODS: We generated a measure of "case-fatality" among young people with diabetes using the mortality-to-incidence ratio (M/I ratio) for 29 industrialized countries using published data on diabetes incidence and mortality. Standardized incidence rates for ages 0-14 years were extracted from the World Health Organization DiaMond study for the period 1990-1994; data on death from diabetes for ages 0-39 years were obtained from the World Health Organization mortality database and converted into age-standardized death rates for the period 1994-1998, using the European standard population. RESULTS: The M/I ratio varied >10-fold. These relative differences appear similar to those observed in cohort studies of mortality among young people with type 1 diabetes in five countries. A sensitivity analysis showed that using plausible assumptions about potential overestimation of diabetes as a cause of death and underestimation of incidence rates in the U.S. yields an M/I ratio that would still be twice as high as in the U.K. or Canada. CONCLUSIONS: The M/I ratio for diabetes provides a means of differentiating countries on quality of care for people with diabetes. It is solely an indicator of potential problems, a basis for stimulating more detailed assessments of whether such problems exist, and what can be done to address them.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Research Centre: ECOHOST - The Centre for Health and Social Change
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 16644629
Web of Science ID: 237278100009
URI: http://researchonline.lshtm.ac.uk/id/eprint/11929


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