{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:46:54Z","timestamp":1788202014570,"version":"build-2803163510"},"reference-count":28,"publisher":"American Diabetes Association","issue":"9","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/501100003635","name":"Health Insurance Review and Assessment Service","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003635","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This study examined the long-term effectiveness of the national diabetes quality assessment program (NDQAP) in diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>From the Health Insurance Review and Assessment Service database, 399,984 individuals with diabetes who visited a primary care clinic from 1 July 2012 to 30 June 2013 were included and followed up until 31 May 2021. The NDQAP included five quality assessment indicators: regular outpatient visits, continuity of prescriptions, regular testing of glycated hemoglobin and lipids, and regular fundus examination. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for diabetes complications and all-cause mortality by the achievement of quality assessment indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>During the mean follow-up duration of 7.6 \u00b1 1.8 years, 20,054 cases (5.0%) of proliferative diabetic retinopathy (PDR), 6,281 end-stage kidney diseases (ESKD; 1.6%), 1,943 amputations (0.5%), 9,706 myocardial infarctions (MIs; 2.4%), 26,975 strokes (6.7%), and 35,799 all-cause mortality (8.9%) occurred. Each achievement of quality assessment indicator was associated with a decreased risk of diabetes complications and all-cause mortality. Individuals who were managed in high-quality institutions had a lower risk of PDR (HR 0.82; 95% CI 0.80\u20130.85), ESKD (HR 0.77; 95% CI 0.73\u20130.81), amputation (HR 0.75; 95% CI 0.69\u20130.83), MI (HR 0.85; 95% CI 0.82\u20130.89), stroke (HR 0.86; 95% CI 0.84\u20130.88), and all-cause mortality (HR 0.96; 95% CI 0.94\u20130.98) than those who were not managed in high-quality institutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In Korea, the achievement of NDQAP indicators was associated with a decreased risk of diabetes complications and all-cause mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc23-0444","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T10:30:10Z","timestamp":1689849010000},"page":"1700-1706","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":12,"title":["Long-term Effectiveness of the National Diabetes Quality Assessment Program in South Korea"],"prefix":"10.2337","volume":"46","author":[{"given":"Ji Hye","family":"Huh","sequence":"first","affiliation":[{"name":"1Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serim","family":"Kwon","sequence":"additional","affiliation":[{"name":"2Department of Quality Assessment, Health Insurance Review and Assessment Service, Wonju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui Ok","family":"Kim","sequence":"additional","affiliation":[{"name":"2Department of Quality Assessment, Health Insurance Review and Assessment Service, Wonju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo Yeon","family":"Kim","sequence":"additional","affiliation":[{"name":"3Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3408-7568","authenticated-orcid":false,"given":"Kyoung Hwa","family":"Ha","sequence":"additional","affiliation":[{"name":"4Department of Endocrinology & Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-2044","authenticated-orcid":false,"given":"Dae Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"4Department of Endocrinology & Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"2023082518541955000_B1","doi-asserted-by":"crossref","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045","volume":"183","author":"Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"2023082518541955000_B2","doi-asserted-by":"crossref","first-page":"417","DOI":"10.4093\/dmj.2022.0106","article-title":"Diabetes fact sheet in Korea 2021","volume":"46","author":"Bae","year":"2022","journal-title":"Diabetes Metab J"},{"key":"2023082518541955000_B3","volume-title":"2021 Clinical Practice Guidelines for Diabetes","author":"Korean Diabetes Association","year":"2021"},{"key":"2023082518541955000_B4","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/eurheartj\/ehz486","article-title":"2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD","volume":"41","author":"Cosentino","year":"2020","journal-title":"Eur Heart J"},{"key":"2023082518541955000_B5","doi-asserted-by":"crossref","first-page":"S158","DOI":"10.2337\/dc23-S010","article-title":"10. Cardiovascular disease and risk management: Standards of Care in Diabetes\u20142023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"2023082518541955000_B6","doi-asserted-by":"crossref","first-page":"S203","DOI":"10.2337\/dc23-S012","article-title":"12. Retinopathy, neuropathy, and foot care: Standards of Care in Diabetes\u20142023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"2023082518541955000_B7","unstructured":"National Institute for Health and Care Excellence\n          . Type 2 diabetes in adults: management. NICE Guideline NG28. Last updated 29 June 2022. Accessed 15 February 2023. Available from https:\/\/www.nice.org.uk\/guidance\/ng28"},{"key":"2023082518541955000_B8","doi-asserted-by":"crossref","first-page":"e025603","DOI":"10.1161\/JAHA.122.025603","article-title":"Longitudinal adherence to diabetes quality indicators and cardiac disease: a nationwide population-based historical cohort study of patients with pharmacologically treated diabetes","volume":"11","author":"Abdel-Rahman","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2023082518541955000_B9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.diabres.2011.02.002","article-title":"Barriers to diabetes management: patient and provider factors","volume":"93","author":"Nam","year":"2011","journal-title":"Diabetes Res Clin Pract"},{"key":"2023082518541955000_B10","doi-asserted-by":"crossref","first-page":"125","DOI":"10.3904\/kjim.2016.136","article-title":"Analysis of diabetes quality assessment findings and future directions for the appropriate management of diabetes in Korea","volume":"34","author":"Kim","year":"2019","journal-title":"Korean J Intern Med"},{"key":"2023082518541955000_B11","unstructured":"Health Insurance Review and Assessment Service\n          . Results of the National Diabetes Quality Assessment Program. Accessed 15 February 2023. Available from https:\/\/www.hira.or.kr\/main.do"},{"key":"2023082518541955000_B12","doi-asserted-by":"crossref","first-page":"161","DOI":"10.15212\/FMCH.2018.0121","article-title":"Adherence to clinical guidelines for monitoring diabetes in primary care settings","volume":"6","author":"Dai","year":"2018","journal-title":"Fam Med Community Health"},{"key":"2023082518541955000_B13","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.2337\/diacare.24.10.1815","article-title":"The Diabetes Quality Improvement Project: moving science into health policy to gain an edge on the diabetes epidemic","volume":"24","author":"Fleming","year":"2001","journal-title":"Diabetes Care"},{"key":"2023082518541955000_B14","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1093\/intqhc\/mzl023","article-title":"Selecting indicators for the quality of diabetes care at the health systems level in OECD countries","volume":"18","author":"Nicolucci","year":"2006","journal-title":"Int J Qual Health Care"},{"key":"2023082518541955000_B15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.pcd.2006.07.001","article-title":"Quality indicators for type-2 diabetes care in practice guidelines: an example from six European countries","volume":"1","author":"Wens","year":"2007","journal-title":"Prim Care Diabetes"},{"key":"2023082518541955000_B16","unstructured":"NHS Digital\n          . National Diabetes Audit, 2019\u201320. Report 1: Care Processes and Treatment Targets 2019\u201320. 12 August 2021. Accessed 15 February 2023. Available from https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/national-diabetes-audit\/report-1-care-processes-and-treatment-targets-2019---20"},{"key":"2023082518541955000_B17","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1016\/S0140-6736(12)60480-2","article-title":"Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis","volume":"379","author":"Tricco","year":"2012","journal-title":"Lancet"},{"key":"2023082518541955000_B18","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.jcjd.2014.06.002","article-title":"Performance-based financial incentives for diabetes care: an effective strategy?","volume":"39","author":"Latham","year":"2015","journal-title":"Can J Diabetes"},{"key":"2023082518541955000_B19","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1370\/afm.1377","article-title":"Pay-for-performance in the United Kingdom: impact of the quality and outcomes framework: a systematic review","volume":"10","author":"Gillam","year":"2012","journal-title":"Ann Fam Med"},{"key":"2023082518541955000_B20","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/j.1464-5491.2010.02951.x","article-title":"Improvements in glycaemic control and cholesterol concentrations associated with the Quality and Outcomes Framework: a regional 2-year audit of diabetes care in the UK","volume":"27","author":"Oluwatowoju","year":"2010","journal-title":"Diabet Med"},{"key":"2023082518541955000_B21","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.2337\/dc11-1402","article-title":"The relationship between financial incentives and quality of diabetes care in Ontario, Canada","volume":"35","author":"Kiran","year":"2012","journal-title":"Diabetes Care"},{"key":"2023082518541955000_B22","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4093\/dmj.2020.0175","article-title":"Trends in cardiovascular complications and mortality among patients with diabetes in South Korea","volume":"45","author":"Park","year":"2021","journal-title":"Diabetes Metab J"},{"key":"2023082518541955000_B23","doi-asserted-by":"crossref","first-page":"258","DOI":"10.2337\/dc15-1194","article-title":"Adherence to oral glucose-lowering therapies and associations with 1-year HbA1c: a retrospective cohort analysis in a large primary care database","volume":"39","author":"Farmer","year":"2016","journal-title":"Diabetes Care"},{"key":"2023082518541955000_B24","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.2337\/dc16-1925","article-title":"Association between adherence to pharmacotherapy and outcomes in type 2 diabetes: a meta-analysis","volume":"40","author":"Khunti","year":"2017","journal-title":"Diabetes Care"},{"key":"2023082518541955000_B25","doi-asserted-by":"crossref","first-page":"398","DOI":"10.2337\/diacare.27.2.398","article-title":"Quality of care and outcomes in type 2 diabetic patients: a comparison between general practice and diabetes clinics","volume":"27","author":"De Berardis","year":"2004","journal-title":"Diabetes Care"},{"key":"2023082518541955000_B26","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.diabres.2012.11.018","article-title":"Trends of ABC control 2006-2011: a national survey of diabetes health promotion institutes in Taiwan","volume":"99","author":"Yu","year":"2013","journal-title":"Diabetes Res Clin Pract"},{"key":"2023082518541955000_B27","doi-asserted-by":"crossref","first-page":"e210","DOI":"10.3346\/jkms.2019.34.e210","article-title":"The need to improve the quality of diabetes care in Korea","volume":"34","author":"Han","year":"2019","journal-title":"J Korean Med Sci"},{"key":"2023082518541955000_B28","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4093\/dmj.2018.0048","article-title":"High proportion of adult cases and prevalence of metabolic syndrome in type 1 diabetes mellitus population in Korea: a nationwide study","volume":"43","author":"Lee","year":"2019","journal-title":"Diabetes Metab J"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc23-0444\/733266\/dc230444.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc23-0444\/733266\/dc230444.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T14:54:56Z","timestamp":1692975296000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/46\/9\/1700\/153426\/Long-term-Effectiveness-of-the-National-Diabetes"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,20]]},"references-count":28,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,7,20]]},"published-print":{"date-parts":[[2023,9,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc23-0444","relation":{"has-preprint":[{"id-type":"doi","id":"10.2337\/figshare.23605560","asserted-by":"object"},{"id-type":"doi","id":"10.2337\/figshare.23605560.v1","asserted-by":"object"},{"id-type":"doi","id":"10.2337\/figshare.23605560.v2","asserted-by":"object"}],"is-supplemented-by":[{"id-type":"doi","id":"10.2337\/figshare.23605560","asserted-by":"object"},{"id-type":"doi","id":"10.2337\/figshare.23605560.v1","asserted-by":"object"},{"id-type":"doi","id":"10.2337\/figshare.23605560.v2","asserted-by":"object"}]},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,20]]}}}