Variation in diabetes care by age: opportunities for customization of care
<p>Abstract</p> <p>Background</p> <p>The quality of diabetes care provided to older adults has usually been judged to be poor, but few data provide direct comparison to other age groups. In this study, we hypothesized that adults age 65 and over receive lower quality di...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2003-10-01
|
| Series: | BMC Family Practice |
| Online Access: | http://www.biomedcentral.com/1471-2296/4/16 |
| _version_ | 1811227565398949888 |
|---|---|
| author | Solberg Leif I Desai Jay R O'Connor Patrick J Rush William A Bishop Donald B |
| author_facet | Solberg Leif I Desai Jay R O'Connor Patrick J Rush William A Bishop Donald B |
| author_sort | Solberg Leif I |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The quality of diabetes care provided to older adults has usually been judged to be poor, but few data provide direct comparison to other age groups. In this study, we hypothesized that adults age 65 and over receive lower quality diabetes care than adults age 45–64 years old.</p> <p>Methods</p> <p>We conducted a cohort study of members of a health plan cared for by multiple medical groups in Minnesota. Study subjects were a random sample of 1109 adults age 45 and over with an established diagnosis of diabetes using a diabetes identification method with estimated sensitivity 0.91 and positive predictive value 0.94. Survey data (response rate 86.2%) and administrative databases were used to assess diabetes severity, glycemic control, quality of life, microvascular and macrovascular risks and complications, preventive care, utilization, and perceptions of diabetes.</p> <p>Results</p> <p>Compared to those aged 45–64 years (N = 627), those 65 and older (N = 482) had better glycemic control, better health-related behaviors, and perceived less adverse impacts of diabetes on their quality of life despite longer duration of diabetes and a prevalence of cardiovascular disease twice that of younger patients. Older patients did not ascribe heart disease to their diabetes. Younger adults often had explanatory models of diabetes that interfere with effective and aggressive care, and accessed care less frequently. Overall, only 37% of patients were simultaneously up-to-date on eye exams, foot exams, and glycated hemoglobin (A1c) tests within one year.</p> <p>Conclusion</p> <p>These data demonstrate the need for further improvement in diabetes care for all patients, and suggest that customisation of care based on age and explanatory models of diabetes may be an improvement strategy that merits further evaluation.</p> |
| first_indexed | 2024-04-12T09:43:32Z |
| format | Article |
| id | doaj.art-b9ffdf57eb814115a4cd2dbeacee1c72 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-12T09:43:32Z |
| publishDate | 2003-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-b9ffdf57eb814115a4cd2dbeacee1c722022-12-22T03:38:00ZengBMCBMC Family Practice1471-22962003-10-01411610.1186/1471-2296-4-16Variation in diabetes care by age: opportunities for customization of careSolberg Leif IDesai Jay RO'Connor Patrick JRush William ABishop Donald B<p>Abstract</p> <p>Background</p> <p>The quality of diabetes care provided to older adults has usually been judged to be poor, but few data provide direct comparison to other age groups. In this study, we hypothesized that adults age 65 and over receive lower quality diabetes care than adults age 45–64 years old.</p> <p>Methods</p> <p>We conducted a cohort study of members of a health plan cared for by multiple medical groups in Minnesota. Study subjects were a random sample of 1109 adults age 45 and over with an established diagnosis of diabetes using a diabetes identification method with estimated sensitivity 0.91 and positive predictive value 0.94. Survey data (response rate 86.2%) and administrative databases were used to assess diabetes severity, glycemic control, quality of life, microvascular and macrovascular risks and complications, preventive care, utilization, and perceptions of diabetes.</p> <p>Results</p> <p>Compared to those aged 45–64 years (N = 627), those 65 and older (N = 482) had better glycemic control, better health-related behaviors, and perceived less adverse impacts of diabetes on their quality of life despite longer duration of diabetes and a prevalence of cardiovascular disease twice that of younger patients. Older patients did not ascribe heart disease to their diabetes. Younger adults often had explanatory models of diabetes that interfere with effective and aggressive care, and accessed care less frequently. Overall, only 37% of patients were simultaneously up-to-date on eye exams, foot exams, and glycated hemoglobin (A1c) tests within one year.</p> <p>Conclusion</p> <p>These data demonstrate the need for further improvement in diabetes care for all patients, and suggest that customisation of care based on age and explanatory models of diabetes may be an improvement strategy that merits further evaluation.</p>http://www.biomedcentral.com/1471-2296/4/16 |
| spellingShingle | Solberg Leif I Desai Jay R O'Connor Patrick J Rush William A Bishop Donald B Variation in diabetes care by age: opportunities for customization of care BMC Family Practice |
| title | Variation in diabetes care by age: opportunities for customization of care |
| title_full | Variation in diabetes care by age: opportunities for customization of care |
| title_fullStr | Variation in diabetes care by age: opportunities for customization of care |
| title_full_unstemmed | Variation in diabetes care by age: opportunities for customization of care |
| title_short | Variation in diabetes care by age: opportunities for customization of care |
| title_sort | variation in diabetes care by age opportunities for customization of care |
| url | http://www.biomedcentral.com/1471-2296/4/16 |
| work_keys_str_mv | AT solbergleifi variationindiabetescarebyageopportunitiesforcustomizationofcare AT desaijayr variationindiabetescarebyageopportunitiesforcustomizationofcare AT oconnorpatrickj variationindiabetescarebyageopportunitiesforcustomizationofcare AT rushwilliama variationindiabetescarebyageopportunitiesforcustomizationofcare AT bishopdonaldb variationindiabetescarebyageopportunitiesforcustomizationofcare |