 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Jay Desai, MPH1, Heather Devlin, MA1, Patrick J O'Connor, MD, MPH2, and Lauren Crain, PhD2. (1) Diabetes Program, Minnesota Department of Health, PO Box 64882, St. Paul, MN 55164-0882, 651/281-9844, jay.desai@health.state.mn.us, (2) HealthPartners Research Foundation, PO Box 1309, Minneapolis, MN 55440-1309
Purpose: To assess changes in patient-reported diabetes risk factors and care from 1995 to 2001. Methods: We surveyed randomly selected adults with diabetes at a Minnesota health plan in 1995 and 2001. Response rates were 78.2% and 64.3%, with 1,564 and 2,565 subjects for analyses. Respondents were grouped into 18-64 year olds diagnosed at <30 years of age on insulin only and with BMI < 25 kg/m2 (Group I, potential type 1 population), 18-64 year olds not meeting these criteria (Group II), and those 65 years and older (Group III). The surveys assess diabetes risk factors and care practices using measures from the BRFSS and other sources. Results: Diagnosis of diabetes within one year increased from 12% to 21% in Group II (p<0.001) and from 7% to 13% in Group III (p<0.001). Obesity has increased 11% (p<0.01) and 24% (p=0.02) in Groups II and III, respectively. Patients reporting being told they had high blood cholesterol increased from 14% to 30% in Group I (p=0.02), and 43% to 59% in Groups II and III (p<0.001). Annual cholesterol checks also increased in Groups II and III from 79% to 91% (p<0.001). Self-reported regular aspirin use, annual flu shots, weekly self-foot checks and daily self-monitoring of glucose levels increased significantly in all three groups. In Groups II and III, those who had an annual A1c test, eye exam, AND foot exam, combined, increased significantly (Group II: 42% to 59%, p<001; Group III: 48% to 59%, p<001). Although not significant, this rate also increased in Group I (64% to 76%). Advice from doctors on a variety of diabetes topics decreased by 50% to 90% depending on the topic, while advice from nurses and other health professionals increased from 30% to 900%. Satisfaction with overall medical care increased in Group III (39% to 51%, p<0.001) and did not change in the other groups. Additional measures on A1c levels, LDL levels, and care utilization will also be presented. Conclusions: New cases of diabetes have increased. There have been substantial diabetes care improvements and changes in how diabetes education is provided in this Minnesota health plan population over this 6-year period. Despite improved care, satisfaction with overall care has remained the same in the younger populations and increased in the older diabetes population.
Learning Objectives:
Keywords: Diabetes, Managed Care
Presenting author's disclosure statement:
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.