Stakeholders’ Perceived Barriers and Successes of Quality Improvement Programs for Patients With Diabetes; Comment on “Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China”

Document Type : Commentary


Department of General Practice and Dental Public Health, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA


Rasooly et al performed a qualitative evaluation to characterize the experiences of 26 stakeholders with the implementation of diabetes-related quality and performance measures delivered in primary healthcare to patients with diabetes in metropolitan China. Results from this cross-sectional investigation identified relevant gaps in primary care delivery for people with diabetes from one major center in China. As diabetes is a prevalent condition worldwide, lessons learned from this research can be useful to guide, refine, and improve quality measurement evaluations in primary care in China and other countries. In this commentary, we comment on the strengths and weaknesses of the study, suggest future directions, and discuss how lessons learned from this research can be helpful to guide, refine, and improve the quality measurement of diabetes care in other countries.


  1. World Health Organization. Quality Health Services. 2020. Accessed November 12, 2022.
  2. Feinberg DT. Crossing the health-care quality chasm: when will evidenced-based medicine take hold? J Child Adolesc Psychopharmacol. 2005;15(4):529-531. doi:1089/cap.2005.15.529
  3. Rasooly A, Pan Y, Tang Z, et al. Quality and performance measurement in primary diabetes care: a qualitative study in urban China. Int J Health Policy Manag. 2022;11(12):3019-3031. doi:34172/ijhpm.2022.6372
  4. Wang L, Peng W, Zhao Z, et al. Prevalence and treatment of diabetes in China, 2013-2018. JAMA. 2021;326(24):2498-2506. doi:1001/jama.2021.22208
  5. National Quality Forum. NQF Begins Accepting Public Comments to Review Quality Measures Used in Federal Programs. 2022. Accessed November 12, 2022.
  6. Jiang DH, O'Connor PJ, Huguet N, Golden SH, McCoy RG. Modernizing diabetes care quality measures. Health Aff (Millwood). 2022;41(7):955-962. doi:1377/hlthaff.2022.00233
  7. Healthy People 2030. Accessed November 23, 2023.
  8. Tan X, Liu X, Shao H. Healthy China 2030: a vision for health care. Value Health Reg Issues. 2017;12:112-114. doi:1016/j.vhri.2017.04.001
  9. Zhang W, Ung COL, Lin G, et al. Factors contributing to patients' preferences for primary health care institutions in China: a qualitative study. Front Public Health. 2020;8:414. doi:3389/fpubh.2020.00414
  • Receive Date: 22 November 2022
  • Revise Date: 30 November 2023
  • Accept Date: 02 December 2023
  • First Publish Date: 02 December 2023