This project is a retrospective analysis of state Medicaid claims data relating to diabetes mellitis treatment under the managed care program. At least 931 adults who adhere to the American Diabetes Association (ADA) standard will be compared with 931 adults who do not adhere to the ADA standards. Analyses include descriptive analyses of costs. The retrospective cohort study design will be used to evaluate quality of care and the risk(rate) of diabetes-related hospitalizations among Black and white Medicaid beneficiaries from Georgia with newly diagnosed diabetes in 1996 and 97 who are followed for 12 months.
Quality of care will be primarily defined according to adherence to the American Diabetes Association recommendations. Patients covariates include race, age, gender, comorbid conditions, county of residence, length of enrollment, number of physician visits, medications as well as health care provider information (age, gender, specialty). The main outcomes measure will be the rate of diabetes-related hospitalization. Costs will be compared among whites and Blacks. An important comparison will be the results of mandatory primary care case management plan compared to other Medicaid beneficiaries. The study will provide an indepth discussion of the patterns of access to care for diabetes mellitis under managed care. It will also highlight the lack of information on the impact that may have on managed care and posits that caring for those with Diabetes under managed care may even be seen as a financial drain for managed care organizations.
Learning Objectives: 1. Assessing quality of care for adults with diabetes. 2. Determining the risk of diabetes-related hospitalizations. 3) Determining the risk of acute complications for adults with diabetes. 4. Identifying the costs of diabetes care among Black and white adult Medicaid beneficiaries enrolled in the Georgia Better Health Care Practice.
Keywords: Cost Issues, Access to Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.