Abstract
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 (> or =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.