TY - JOUR
T1 - Diabetes care among veteran women with disability
AU - Tseng, Chin Lin
AU - Sambamoorthi, Usha
AU - Tiwari, Anjali
AU - Rajan, Mangala
AU - Findley, Patricia
AU - Pogach, Leonard
N1 - Funding Information:
Supported partially by grant from the Veteran Affairs Medical Service Epidemiology Grant and the VA Diabetes QUERI Coordinating Center (L.P.) and by NIH K23 HD 40779-4 (to P.F.). The findings and opinions reported here are those of the authors and do not necessarily represent the views of the Veterans Health Administration or any other organizations.
PY - 2006/11
Y1 - 2006/11
N2 - Objective: The primary objective of this study was to analyze predictors of diabetes care consistent with performance standards among women Veterans Health Administration (VHA) clinic users with disability enrollment status. Methods: This is a retrospective cohort study using VHA and Medicare files of VHA clinic users with diabetes. Diabetes care measures consisted of annual testing for hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), and poor HbA1c (>9%) and LDL-C (≥130 mg/dL) control in fiscal year 2000. Chi-square tests and logistic regressions were used to assess subgroup differences in diabetes care. Independent variables included demographic characteristics and physical and psychiatric comorbidities. Population: Study population was based on veteran women <65 years of age who used VHA clinics; we identified 2,344 women as having coexisting disability and diabetes and 2,766 women with diabetes and without disability. Findings: Among veteran women with diabetes and disability, 65% received ≥1 HbA1c test, and 54% received a LDL-C test; 25% and 30% had poor HbA1c and LDL-C control, respectively. In logistic regressions, none of the independent variables had significant effects on poor HbA1c or LDL-C control, except that African Americans were more likely to have poor HbA1c control than whites. Significant age effects were noted in rates of HbA1c and LDL testing. Comparison of diabetes care measures between women with and without disability indicated that those with disability were more likely to receive HbA1c and LDL-C tests; no significant differences in HbA1c and LDL-C control were noted. Conclusions: Disability status of women veterans was not a barrier to diabetes care consistent with performance standards. Our findings suggest that to improve diabetes care, subgroup-specific interventions, rather than a global approach, are warranted.
AB - Objective: The primary objective of this study was to analyze predictors of diabetes care consistent with performance standards among women Veterans Health Administration (VHA) clinic users with disability enrollment status. Methods: This is a retrospective cohort study using VHA and Medicare files of VHA clinic users with diabetes. Diabetes care measures consisted of annual testing for hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), and poor HbA1c (>9%) and LDL-C (≥130 mg/dL) control in fiscal year 2000. Chi-square tests and logistic regressions were used to assess subgroup differences in diabetes care. Independent variables included demographic characteristics and physical and psychiatric comorbidities. Population: Study population was based on veteran women <65 years of age who used VHA clinics; we identified 2,344 women as having coexisting disability and diabetes and 2,766 women with diabetes and without disability. Findings: Among veteran women with diabetes and disability, 65% received ≥1 HbA1c test, and 54% received a LDL-C test; 25% and 30% had poor HbA1c and LDL-C control, respectively. In logistic regressions, none of the independent variables had significant effects on poor HbA1c or LDL-C control, except that African Americans were more likely to have poor HbA1c control than whites. Significant age effects were noted in rates of HbA1c and LDL testing. Comparison of diabetes care measures between women with and without disability indicated that those with disability were more likely to receive HbA1c and LDL-C tests; no significant differences in HbA1c and LDL-C control were noted. Conclusions: Disability status of women veterans was not a barrier to diabetes care consistent with performance standards. Our findings suggest that to improve diabetes care, subgroup-specific interventions, rather than a global approach, are warranted.
UR - http://www.scopus.com/inward/record.url?scp=33845562282&partnerID=8YFLogxK
U2 - 10.1016/j.whi.2006.07.001
DO - 10.1016/j.whi.2006.07.001
M3 - Article
C2 - 17188219
AN - SCOPUS:33845562282
VL - 16
SP - 361
EP - 371
JO - Women's Health Issues
JF - Women's Health Issues
SN - 1049-3867
IS - 6
ER -