title: [Typical management practice in outpatients with type 2 diabetes mellitus in cities, towns, and villages].
abstract: OBJECTIVE
  To analyze one-year typical management practice in outpatients with type 2 diabetes mellitus (T2DM) in cities, towns, and villages.
  
  
  METHODS
  438 records of T2DM outpatients regularly visiting their physicians during 2009 were retrospectively analyzed. Group 1 included 221 outpatients from 7 polyclinics of the Kirov Regional Center; Group 2 consisted of 227 patients from 36 districts of the Kirov Region. VEN-, ABC-, and frequency analyses were made; the costs of drug therapy and hospitalization for the included patients were calculated.
  
  
  RESULTS
  The investigation revealed the low efficiency of sugar-lowering therapy (SLT), insufficient glycated hemoglobin testing rates (15% in Group 2 during a year), inadequate correction of SLT. During one year the number of patients with fixed target office blood pressure levels in Group 1 increased from 16.6 to 34.1% (р<0.001) and that in Group 2 was statistically significantly unchanged (21.6% vs 25.1%; p=0.05). In Group 2, the use frequency of statins was lower (20.3% by the end of the year versus 49.3% in Group 1; р<0.001); the examination quality was worse; the drugs with unproven efficacy, the cost of which was higher than that of statins/disaggregants, were used more often. In Groups 1 and 2, there were 50 (23.7%) and 95 (41.9%) patients who were more commonly hospitalized for T2DM-related causes; Group 2 patients had a higher rate of hospitalizations and longer inpatient treatment.
  
  
  CONCLUSIONS
  The worse outpatient care quality in the towns and villages was followed by increases in a need for inpatient treatment and in direct drug (2.36-fold) and non-drug direct and indirect (2.77-fold) costs.
authors.affiliation: Kirov State Medical Academy, Ministry of Health of Russia, Kirov, Russia.
authors.forename: I E
authors.initials: IE
authors.lastname: Sapozhnikova
authors.affiliation: Nizhny Novgorod State Medical Academy, Ministry of Health of Russia, Nizhny Novgorod, Russia.
authors.forename: E I
authors.initials: EI
authors.lastname: Tarlovskaya
authors.affiliation: Institute of Applied Economic Researches, Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
authors.forename: M V
authors.initials: MV
authors.lastname: Avksentyeva
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006301:Health Services Needs and Demand; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management / Q000379:methods / Q000458:organization & administration / Q000592:standards; D011785:Quality Assurance, Health Care / Q000379:methods; D012111:Residence Characteristics; D019035:Rural Health Services / Q000191:economics / Q000592:standards; D012426:Russia / Q000453:epidemiology; D019037:Urban Health Services / Q000191:economics / Q000592:standards