McMurry Timothy L, Lobo Jennifer M, Kang Hyojung, Kim Soyoun, Balkrishnan Rajesh, Anderson Roger, McCall Anthony, Sohn Min-Woong
Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, United States.
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States.
Diabet Epidemiol Manag. 2022 Jul-Sep;7. doi: 10.1016/j.deman.2022.100094. Epub 2022 Jul 18.
To examine whether Annual Wellness Visits (AWVs) were associated with increased use of preventive services in Medicare patients with diabetes living in the Diabetes Belt.
We used a case-control design where outcomes were utilization of preventive services recommended for patients with diabetes (foot exam, eye exam, A1c test, and microalbuminuria test) and the exposure was AWVs using data for Medicare patients with diabetes in 2014 - 2015 residing in the Diabetes Belt (N = 412,009).
Only 13.4% of patients in 2014 and 17.4% in 2015 used AWVs. Eye exams (61% vs 53%), foot exams (93% vs 79%), A1c tests (81% vs 71%), and microalbuminuria tests (45% vs 28%) were more common among patients who had an AWV in the preceding year compared with those who did not. These differences remained significant after adjusting for patient demographics, comorbidities, county level medical resources, and geographic factors.
AWVs were significantly associated with increased preventive care use among patients with diabetes living in the Diabetes Belt. Low AWV utilization by patients with diabetes in and around the Diabetes Belt is concerning.
探讨年度健康检查(AWVs)是否与生活在糖尿病带的医疗保险糖尿病患者预防性服务使用增加有关。
我们采用病例对照设计,结局指标为糖尿病患者推荐的预防性服务(足部检查、眼科检查、糖化血红蛋白(A1c)检测和微量白蛋白尿检测)的使用情况,暴露因素为使用2014 - 2015年生活在糖尿病带的医疗保险糖尿病患者的数据进行的年度健康检查(N = 412,009)。
2014年仅有13.4%的患者和2015年17.4%的患者使用了年度健康检查。与未进行年度健康检查的患者相比,前一年进行年度健康检查的患者中眼科检查(61%对53%)、足部检查(93%对79%)、糖化血红蛋白检测(81%对71%)和微量白蛋白尿检测(45%对28%)更为常见。在调整患者人口统计学、合并症、县级医疗资源和地理因素后,这些差异仍然显著。
年度健康检查与生活在糖尿病带的糖尿病患者预防性护理使用增加显著相关。糖尿病带及其周边地区糖尿病患者年度健康检查利用率较低令人担忧。