[Outpatient care of patients with diabetes mellitus in 2001. Analysis of a health insurance sample of the AOK in Hesse/KV in Hesse].
OBJECTIVE
Aim of this retrospective case-control study was to assess the quality of out-patient care in patients with diabetes mellitus by analysing health insurance data from a large cohort of members of a regional statutory health insurance fund in Hesse.


METHODS
The study was carried out in the 'Versichertenstichprobe AOK Hessen/KV Hessen', a 18.75% random sample of the AOK Hesse, for the year 2001 corresponding to 306,736 subjects and 26,972 diabetics. All medical services and prescriptions provided by primary-care physicians were documented.


RESULTS
Compared to an age- and sex-matched control group patients with diabetes received more out-patient medical services (diabetics: 126 +/- 0.8, controls: 76 +/- 0.4 per year, p < 0.0001) and more prescriptions (diabetics: 39.9 +/- 0.3, controls: 20.0 +/- 0.3 per year, p < 0.0001) in 2001. HbA (1c) measurements were performed in 69.5% of the insulin-treated patients, in 64.3% of the patients under monotherapy with oral hypoglycaemic agents and in 41.1% of the patients under dietary treatment. 78.1% of the insulin-treated patients, 12.0% of those under oral hypoglycaemic agents and 2.0% of patients under dietary treatment received prescriptions for material for blood glucose self-monitoring. In contrast, a retinal examination was performed in only 45.8%, 31.1% and 22.5% of the patients in the three treatment groups throughout the year. The respective figures for screening for microalbuminuria in the three treatment groups were 12.7%, 7.1% and 3.6%.


CONCLUSIONS
The results of this retrospective analysis suggest that the out-patient medical care of subjects with diabetes is in some respect unsatisfactory and does not comply with the accepted recommendations for appropriate diabetes care.
Hauner
H
H
Else-Kröner-Fresenius-Zentrum für Ernährungsmedizin der Technischen Universität Munich. hauner@wzw.tum.de
Köster
I
I
von Ferber
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D003927:Diet, Diabetic; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin / Q000031:analogs & derivatives* / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012189:Retrospective Studies
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C025617:glucosylated hemoglobin A