JRSM > Volume 99, Number 11 > Pp. 576-581

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Association of age, sex and deprivation with quality indicators for diabetes: population-based cross sectional survey in primary care

Jeremy Gray¹ Christopher Millett^2,3 Caoimhe O'Sullivan^5,7 Rumana Z Omar^6,8   Azeem Majeed⁴

¹ Director, Wandsworth Primary Care Research Centre, London SW11 6HN
² Specialist Trainee in Public Health, Wandsworth Primary Care Research Centre, London SW11 6HN
³ Specialist Trainee in Public Health, Department of Primary Care & Social Medicine, Imperial College Faculty of Medicine, London W6 8RP
⁴ Professor of Primary Care, Department of Primary Care & Social Medicine, Imperial College Faculty of Medicine, London W6 8RP
⁵ Medical Statistician, Medical Statistics Unit, Research & Development Directorate, University College London Hospitals, London WC1E 5DB
⁶ Senior Lecturer in Medical Statistics, Medical Statistics Unit, Research & Development Directorate, University College London Hospitals, London WC1E 5DB
⁷ Medical Statistician, Department of Statistical Science, University College London, London WC1E 6BT, UK
⁸ Senior Lecturer in Medical Statistics, Department of Statistical Science, University College London, London WC1E 6BT, UK

Correspondence to: Christopher Millett, Specialist Trainee in Public Health, Department of Primary Care & Social Medicine, Imperial College Faculty of Medicine, 3rd Floor, Reynolds Building, St Dunstan's Road, London W6 8RP, UK E-mail: c.millett{at}imperial.ac.uk

Objectives To determine the quality of diabetes management in primary care after the publication of the National Service Framework and examine the impact of age, gender and deprivation on the achievement of established quality indicators.

Design Population-based cross sectional survey using electronic general practice records carried out between June-October 2003.

Setting Thirty-four practices in Wandsworth, South-West London, UK.

Participants 6035 adult patients (18 years) with diabetes from a total registered population of 201 572 patients.

Interventions None.

Main outcome measures Success rates for the diabetes quality indicators within the General Medical Services contract for general practitioners.

Results We identified large variations in diabetes management between general practitioner practices with poorer recording of quality care in younger patients (18-44 years). In addition, younger patients had a worse cholesterol and glycaemia profile, although hypertension was more common in older patients. Gender and deprivation did not appear to be important determinants of the quality of care received.

Conclusions There are large variations in diabetes management between general practitioner practices, with care seemingly worse for younger adults. Longitudinal studies are required to determine whether current UK quality improvement initiatives have been successful in attenuating existing variations in care and treatment outcomes.

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