Daniel T. McCall|Angela Sauaia|Richard F. Hamman|Jane E.B. Reusch|Phoebe Lindsey Barton
Are Low-Income Elderly Patients at Risk for Poor Diabetes Care?
Arkansas Foundation for Medical Care|Downtown Women's Health Care|University of Colorado Hospital|University of Colorado Health|University of Colorado Denver|University of Colorado Hospital|University of Colorado Health|University of Colorado Denver|University of Colorado Hospital|University of Colorado Health|University of Colorado Denver
objectivediabetes common among lowincome elderly dualeligible de medicaremedicaid patients resulting significant morbidity mortality cost however quality diabetes care delivered patients evaluated aims study describe quality diabetes care provided de patients compare nonde patients research design methodsthis crosssectional analysis administrative claims 1 january 1997 31 december 1998 total 9453 patients aged 6575 years diabetes participated study colorado medicare feeforservice ffs outpatients main outcome measures consisted proportion patients receiving annual hemoglobin a1c test biennial eye examination biennial lipid test three care processes resultsthe mean patient age 71 28 years 22 patients identified dual eligible significantly likely younger female minority raceethnicity reside rural location comorbid conditions compared nonde population de patients visits primary care physicians emergency departments hospitalizations less likely visit endocrinologists de patients significantly less likely receive annual a1c test 73 vs 81 p amplt 00001 biennial ophthalmologic examination 63 vs 75 p amplt 00001 biennial lipid testing 43 vs 57 p amplt 00001 adjusted odds ratio urban de patients receiving three care measures 060 95 ci 052069 compared urban nonde patients minority raceethnicity emergency department use significantly associated receiving diabetes care whereas endocrinology visits associated increased odds receiving diabetes care conclusionsde medicaremedicaid status independently associated receiving diabetes care especially among urban areas