[Quality management in diabetology by the PC software program DIQUAL]

Today, effective therapies for patients with diabetes mellitus. However, these therapeutic strategies are often not or incorrectly applied. Following these discrepancies for health care providers, it is mandatory to document the efficacy of diabetes treatment. However, it is hard to prove the outcome of diabetes care because of unsuitable documentation, missing parameters and different definitions of quality indicators. The computer programme DIQUAL was developed to improve the diabetes management on the diabetes ward, the diabetes out-patient department and for the documentation of outcome quality. DIQUAL is a patient database and offers structured data collecting and administration, text processing, referring letters, application and list functions, internal and external quality control, as well as cohort or cross-section analysis, data export function for nation wide data collection, system internal plausibility check and extension modules for scientific studies. On the basis of DIQUAL, the first nation wide comparison of outcome quality in the routine treatment of type 1 diabetes was possible. In 1998, we analysed the original data of 1789 patients from 32 district and university hospitals on the basis of the therapeutic goals. HbA1C decreased 1.8% and the incidence of severe hypoglycaemia was lowered to the half. There was a substantial improvement of processes in the health care institutions and the quality of information transmission to the general practitioners. This system of measurement and improvement of quality is also suitable for other areas in health care and medicine.