Determinants of glycemic status monitoring in Black and White Medicaid beneficiaries with diabetes mellitus.
Routine monitoring of glycemic status during regularly scheduled physician office visits is not performed according to recommended guidelines for most people with diabetes. We conducted this investigation to identify the determinants of glycemic status monitoring during primary care office visits among Black and White adult Medicaid beneficiaries diagnosed with type 2 diabetes in 1996 and 1997 and followed for a 12-month period through year 1997 and year 1998, respectively (N=3,321). Multivariate logistic regression analyses indicated that the likelihood of receiving the American Diabetes Association (ADA) recommended 2 or more HbA1c tests was more than 2 times greater for persons with diabetes who had 10 or more visits than for those with only one visit in the one-year period since initial diagnosis (relative risk (RR) = 2.31, 95% confidence interval (CI) = 1.51-3.51). Quality improvement efforts that emphasize the patient-primary provider relationship and better coordination of care will improve adherence to diabetes care standards.
Mayberry
Robert Morris
RM
Program for Healthcare Effectiverness Research, Dept. of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA. mayberry@msm.edu
Davis
Trobiand
T
Alema-Mensah
Ernest
E
Samadi
Aziz R
AR
Finley
Rita
R
Jones
Alma
A
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000208:ethnology*; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012189:Retrospective Studies; D044465:White People
D001786:Blood Glucose; D006442:Glycated Hemoglobin