Diabetes management by hospital-affiliated diabetes centres in Lazio, Italy

BACKGROUND: In Italy, diabetes centres are considered to provide adequate care but little is known about their performance. METHODS: Inpatient and outpatient administrative databases were used to select and study a cohort of 2,568 diabetic patients. Adherence to guidelines and effect of patient characteristics and diabetes centre on treatment was assessed. Mortality rate was calculated. RESULTS: Patients averaged 9.3 outpatient visits per year. Each patient received a mean of 21.8 ambulatory services per year but only 2.21 Haemoglobin A1C tests, and only 0.56 procedures suggested by the guidelines. Diabetes management depended mainly on the care centre. A mortality rate of 6.9 per hundred person-years was observed. CONCLUSIONS: Hospital-affiliated centres do not ensure adequate diabetes management.