scholarly journals Trends and Disparities in Quality of Diabetes Care in the US: The National Health and Nutrition Examination Survey, 1999-2016

2019 ◽  
Vol 10 (4) ◽  
pp. 17
Author(s):  
Shweta Kamat ◽  
Yolene Gousse ◽  
Jagannath Muzumdar ◽  
Anna Gu
Keyword(s):  
Health Insurance ◽  
Diabetes Care ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
The United States ◽  
Original Research ◽  
The Past ◽  
Diabetes Educator ◽  
Quality Of Diabetes Care

Objectives: To examine trends and disparities in the quality of diabetes care among US adults with diabetes. Methods: Individuals aged 20 years or older with diabetes from NHANES (1999-2016) were included in the study. Quality indicators for diabetes care included Hemoglobin A1c (HbA1c) < 8%, Blood Pressure (BP) < 130/80 mm Hg, Low-Density Lipoprotein (LDL-C) < 100 mg/dL, triglycerides < 150 mg/dL, receiving eye and foot examinations in the past year, and meeting with a diabetes educator in the past year. Results: A total of 7,521 adults with diabetes were identified. During the 18-year study period, significant improvements in diabetes care were observed in the overall study sample. Adjusted regression analyses showed that compared with their White counterparts, Blacks were more likely to have received eye (OR=1.37; P=0.01) and foot (OR=1.42;P=0.01) examinations and met a diabetes educator (OR=1.40;P<0.01) over the past year. However, Blacks were significantly less likely to achieve treatment goals for HbA1c (OR=0.77, P=0.02), BP (OR=0.75, P<0.01), LDL-C (OR=0.68, P<0.01). Hispanics in general had suboptimal healthcare utilization for diabetes but the Hispanic-white disparities in diabetes care outcomes were attenuated after controlling for patient sociodemographic, clinical and utilization characteristics. Overall, suboptimal quality of diabetes care were particularly prominent among adults without health insurance and those with lower educational attainment. Conclusions: In the United States, despite persistent efforts, racial disparities in quality of diabetes care still persist. Lack of health insurance and lower socioeconomic status are among the strongest predictors of poor quality of diabetes care. These findings provide valuable information in developing policies and practices to promote racial equity in diabetes care.    Article Type: Original Research

scholarly journals Quality of Diabetes Care in Primary Health Centres in North Al-Batinah of Oman

2014 ◽  
Vol 8 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Mohammed Al-Shafaee ◽  
Yousuf Al-Farsi ◽  
Yousuf Al-Kaabi ◽  
Yajnavalka Banerjee ◽  
Najat Al-Zadjali ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Cross Sectional ◽  
Primary Health ◽  
Quality Of Diabetes Care ◽  
The Mean

Objective: To assess the quality of diabetic care provided in primary health care settings in Oman. Methods: This was a cross-sectional study of randomly selected 500 patients with diabetes mellitus (DM) attending 6 primary care diabetic clinics in the north Al-Batinah region of Oman from January to December 2010. Nine standards on the quality of diabetes care were audited. Results: The mean age of the sample was 51±13 years, ranging from 15 to 87 years; the majority (61%) were females. The mean duration of DM was 4±3 years, ranging from 1 to 18 years. Seventy-seven percent of the patients attended diabetic clinics at least 4 times per year. Of the 9 assessed diabetic standards, HbA1c was documented in 33% of the patients, body mass index in 12%, low-density lipoprotein cholesterol (LDL-C) in 40%, urinary albumin:creatinine ratio in 28%, creatinine in 63% and blood pressure (BP) in 96%. Optimal control among the documented indicators was noted in 32, 21, 25, 85, 95 and 19%, respectively. Twenty percent of the patients had their ECGs done while only 39% of the patients had foot examination. No patient had attained control in all of HbA1c., BP and LDL-C. Conclusion: There is a gap between the recommended DM care guidelines and current practice with consequent poor quality of care in these patients.

scholarly journals The effects of National Health Insurance Scheme on equity and quality of diabetes care in secondary healthcare facilities in SouthWest Nigeria

2018 ◽  
Vol 7 (1) ◽  
pp. 11-21
Author(s):  
S. A. Saka ◽  
O. T. Fajemirokun
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Pharmaceutical Care ◽  
National Health Insurance ◽  
Diabetes Care ◽  
National Health Insurance Scheme ◽  
Insurance Scheme ◽  
Quality Of Diabetes Care ◽  
Southwest Nigeria

There have been concerns about the influence of the National Health Insurance Scheme (NHIS) on equity and quality of diabetes care in many healthcare settings. This study aimed to assess the effects of NHIS onequity and quality of diabetes care (DC) in Nigeria. A prospective cross-sectional study was carried out among 110 (insured n=42, uninsured=68) consenting type 2-diabetics. Diabetic outpatients on oral hypoglycemic drugs, with at least 4 clinic visits prior to the time of the study were consecutively selected at two NHIS accredited public hospitals in Southwest, Nigeria. Patients’ perceptions of equity and quality of DC were assessed using a validated 27 items questionnaire. The medical care and pharmaceutical care in diabetes were independently assessed using medical chart review and a direct observation of dispensing pharmacists’ activities respectively. Chi-squared test was used to determine associations between variables. Majority (61.8%) of the study participants were uninsured. Females (50.9%) were more than the males (49.1%), 40.0% had post-secondary qualifications. The mean ages for the insured and uninsured were 52.02±11.6 and 58.97± 9.3years respectively. The insured and the uninsured differ in their perceptions of drug availability (p<0.001). The pharmacists’ counselling time (p<0.001) differs between the groups. The quality of medical care provided to the diabetics was generally low. The NHIS did not influence the quality of DC, though it may have engendered inequity in pharmaceutical care in the facilities.Journal of Medical and Biomedical Sciences (2018) 7(1), 11 - 21

scholarly journals Team-based care improves quality of diabetes care -Family Practice Integrated Care Project in Taiwan

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Jerry Che-Jui Chang ◽  
Shinn-Jang Hwang ◽  
Tzeng-Ji Chen ◽  
Tai-Yuan Chiu ◽  
Hsiao-Yu Yang ◽  
...  
Keyword(s):  
Integrated Care ◽  
Family Practice ◽  
Diabetes Care ◽  
Conditional Logistic Regression ◽  
Density Lipoprotein ◽  
Fiscal Year ◽  
Diabetic Patients ◽  
Care Project ◽  
Quality Of Diabetes Care

Abstract Background The Family Practice Integrated Care Project (FPICP) is a team-based program in Taiwan initiated in 2003. This study investigates the influence of FPICP on the quality of diabetes care. Methods This population-based cohort study used Taiwan’s National Health Insurance Administration data on FPICP (fiscal year 2015–2016, with follow-up duration of one year). Participants included diabetic patients aged ≥30 in primary care clinics. We used conditional logistic regression modeling of patient characteristics and annual diabetes examinations and compared FPICP participants with non-participating candidates. Main outcome measures included completion of annual diabetes examinations, including glycated hemoglobin (A1c), low-density lipoprotein (LDL), urine microalbumin (MAU), routine urinalysis (UR), and fundus examination (FE). Results The sample included 298,208 FPICP participants and 478,778 non-participating candidates. After 1:1 propensity score matching, the examination completion rates for FPICP participants and non-participants, respectively, were 94.4% versus 93.6% in A1c, 84.2% versus 83.8% in LDL, 61.9% versus 60.1% in MAU, 59.2% versus 58.0% in UR, and 30.1% versus 32.4% in FE. Conclusion Our findings indicate that a program like FPICP helps improve the quality of diabetes care through regular examinations of Alc, LDL, MAU, and UR.

scholarly journals The health care for diabetic persons in Italy: the QUADRI survey

2008 ◽  
Vol 2 (3) ◽  
pp. 143-149
Author(s):  
Marina Maggini ◽  
Valerio Aprile ◽  
Sandro Baldissera ◽  
Angelo D’Argenzio ◽  
Salvatore Lopresti ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Diabetic Patients ◽  
Haemoglobin A1c ◽  
Optimal Care ◽  
The Past ◽  
Italian National Health Service ◽  
Quality Of Diabetes Care ◽  
Italian National Health ◽  
Integrated Case Management

To obtain regional and national data on the quality of diabetes care within the Italian National Health Service, a national survey among persons with diabetes was conducted in 2004. A sample of 3,426 diabetic patients (age 18-64 years) were interviewed using a standardized questionnaire. The population was middle-aged (median age 57 years), had a low educational level, and was followed primarily in public diabetes centres. A total of 54% reported having hypertension but 14% were not on treatment; for hypercholesterolemia, the corresponding figures were 44% and 26%. Of the 72% who were overweight or obese, 51% were trying to lose weight; 26% currently smoked. Only 66% of patients had undergone haemoglobin A1c testing in the past four months (among the 67% who had ever heard of test); 30% suffered from microvascular or macrovascular complications. Only 5% received all eight main tests recommended by the guidelines within the specified intervals. Our study demonstrates that diabetic patients receive less than optimal care, they are engaged in unhealthy behaviours and received inadequate treatment for comorbidities, and that the translation of guidelines into clinical practice was unsatisfactory. These data have been used to formulate national and regional policy regarding integrated case management to improve the quality of diabetes care.

Program Lifts The Quality of Diabetes Care

2010 ◽  
Vol 40 (14) ◽  
pp. 58-59
Author(s):  
MICHELE G. SULLIVAN
Keyword(s):  
Diabetes Care ◽  
Quality Of Diabetes Care
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