Improving diabetes care in the uninsured: the success of the Access To Care program in Cook County, Illinois.

Previous studies have shown that the uninsured receive a lower level of care and that their uninsured status is a risk factor for poorly controlled diabetes mellitus (DM). The Access To Care (ATC) program in Cook County, Illinois provides care to uninsured individuals who do not qualify for other public aid. The aim of our study was to evaluate DM management at Loyola University Health System's ATC clinic. We compared ATC patients and insured patients at Loyola using processes of care and outcome measures outlined by the National Diabetes Quality Improvement Alliance. We found that the ATC group was equivalent in all processes of care. There were no differences in hemoglobin A1C or blood pressure while ATC patients had lower cholesterol. To our knowledge, this is the first study describing a clinic for the uninsured with a level of DM care and outcomes equivalent to those of insured individuals.