title: Delivery of Care to Nursing Home Residents With Diabetes: Results From the SHELTER Study.
abstract: To describe health care and preventive service provision to nursing home (NH) residents with diabetes mellitus (DM) and to analyze factors determining use of selected services.
  
  
  
  In the period between 2009 and 2011, the Services and Health for Elderly in Long TERm care (SHELTER) project, a 12-month prospective cohort study, was conducted to assess 4037 NH residents aged 60 years and older residing in 59 NHs in 7 European countries and Israel.
  
  
  
  The InterRAI tool for long-term care facilities was used to assess care needs and provided health care services. Descriptive statistics and multivariate logistic regression were applied to describe differences between NH residents with (DR) and without DM (non-DR), and to find factors determining use of services and care provided to both groups.
  
  
  
  DR more often than non-DR were hospitalized (18.2% vs 14.3%) and required rehabilitation (23.8% vs 18.2%) or clinically complex care (15.9% vs 13.7%). They also more frequently received a repositioning program (26.8% vs 22.7%), a wound care (15.1% vs 9.8%), and some preventive services as yearly eye examination (41.0% vs 35.9%), pneumococcal vaccination (33.5% vs 26.6%), mammography in women (12.1% vs 7.4%), and colonoscopy (5.6% vs 3.6%). Yet, rates of some of them (mammography, colonoscopy, hearing and dental examinations) were very low in both study cohorts with exception of annual influenza vaccination (82.1%) and yearly blood pressure checkup (95.0%). Interestingly, DM enhanced odds only for mammography [odds ratio (OR) 1.55, 95% confidence interval [CI] 1.15-2.09, P = .004) and eye examination (OR 1.21, 95% CI 1.03-1.42; P = .018).
  
  
  
  DR more frequently receive care related to DM clinical complexity; nevertheless, the recommended frequency of preventive procedures is not met both in DR and non-DR.
authors.affiliation: Unit for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland. Electronic address: katarzyna.szczerbinska@uj.edu.pl.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Szczerbińska
authors.affiliation: Department of Geriatrics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Topinková
authors.affiliation: Unit for Research on Aging Society, Department of Sociology of Medicine, Epidemiology and Preventive Medicine Chair, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Brzyski
authors.affiliation: EMGO Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Henriette G
authors.initials: HG
authors.lastname: van der Roest
authors.affiliation: Department of Geriatrics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Richter
authors.affiliation: Unit for Ageing and Services, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Harriet
authors.initials: H
authors.lastname: Finne-Soveri
authors.affiliation: Agaplesion Bethesda Clinic, Geriatric Centre Ulm/Alb-Donau, University of Ulm, Ulm, Germany.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Denkinger
authors.affiliation: The Centre for Standards in Health and Disability, Research Authority, University of Haifa, Haifa, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Gindin
authors.affiliation: Centro Medicina dell'Invecchiamento, Università Cattolica Sacro Cuore, Rome, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.affiliation: Centro Medicina dell'Invecchiamento, Università Cattolica Sacro Cuore, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care; D003920:Diabetes Mellitus; D005060:Europe; D005260:Female; D006801:Humans; D007557:Israel; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011315:Preventive Medicine; D011446:Prospective Studies
keywords: Diabetes mellitus; care delivery; nursing home; older adults; preventive services