Diabetes Quality of Care and Maintenance in New England: Can Cross-State Collaboration Move Us Forward?
ORIGINAL RESEARCH — Volume 15 — December 27, 2018
PEER REVIEWED
A sign posted on a telephone pole says the following: Cash for sealed and unexpired diabetic test strips. 1-800-771-5589.
Figure 1.
Sign advertising offers to buy diabetes test strips. Photo produced by author.
Figure 2.
Adjusted odds ratios for diabetes maintenance activities in 5 New England states, 2015 and 2016. Covariates were race/ethnicity, age group, education, sex, insurance (yes or no), sole adult in household, any leisure-time physical activity, current smoker, and state of residence. A, Adjusted odds ratio by FPL, where reference group is <200% of the FPL. B, Adjusted odds ratio by race/ethnicity, where reference group is non-Hispanic white. Error bars indicate 95% confidence intervals. Data sources: 2015 Connecticut BRFSS, 2015 Maine BRFSS, 2016 Massachusetts BRFSS, 2015 Rhode Island BRFSS, 2015 Vermont BRFSS. Abbreviations: BRFSS, Behavioral Risk Factor Surveillance System; FPL, federal poverty level; HbA1c, hemoglobin A1c.
| Category | Adjusted Odds Ratio (95% Confidence Interval) |
|---|---|
| A, By Federal Poverty Level (FPL) | |
| 200-399% FPL | |
| <2 HbA1c tests in past year | 1.24 (0.73–2.11) |
| No eye examination in past year | 0.80 (0.47–1.36) |
| No foot examination in past year | 0.81 (0.46–1.44) |
| Incomplete annual diabetes care | 0.91 (0.59–1.41) |
| Had never taken a course or class on diabetes self-management | 1.13 (0.75–1.70) |
| Did not know the number of HbA1c tests received in past year or did not know what an HbA1c test is | 0.57 (0.23–1.39) |
| Did not see provider about diabetes in past year | 1.32 (0.67–2.58) |
| Never examines feet | 1.16 (0.63–2.13) |
| Diabetes-related retinopathy | 0.88 (0.48–1.63) |
| ≥400% FPL | |
| <2 HbA1c tests in past year | 2.06 (1.04–4.08) |
| No eye examination in past year | 0.77 (0.43–1.38) |
| No foot examination in past year | 1.41 (0.79–2.53) |
| Incomplete annual diabetes care | 1.45 (0.89–2.34) |
| Had never taken a course or class on diabetes self-management | 0.83 (0.51–1.38) |
| Did not know the number of HbA1c tests received in past year or did not know what an HbA1c test is | 0.20 (0.05–0.78) |
| Did not see provider about diabetes in past year | 1.14 (0.45–2.89) |
| Never examines feet | 1.48 (0.68–3.20) |
| Diabetes-related retinopathy | 0.41 (0.22–0.75) |
| B, By Race/Ethnicity | |
| Hispanic/Latino | |
| <2 HbA1c tests in past year | 1.21 (0.59–2.45) |
| No eye examination in past year | 0.89 (0.47–1.68) |
| No foot examination in past year | 1.83 (1.01–3.29) |
| Incomplete annual diabetes care | 1.57 (0.83–2.98) |
| Had never taken a course or class on diabetes self-management | 0.99 (0.57–1.75) |
| Did not know the number of HbA1c tests received in past year or did not know what an HbA1c test is | 2.74 (1.15–6.56) |
| Did not see provider about diabetes in past year | 0.87 (0.34–2.20) |
| Never examines feet | 1.43 (0.73–2.82) |
| Diabetes-related retinopathy | 3.13 (1.61–6.10) |
| Non-Hispanic black | |
| <2 HbA1c tests in past year | 1.29 (0.58–2.86) |
| No eye examination in past year | 0.85 (0.36–1.99) |
| No foot examination in past year | 0.90 (0.41–1.96) |
| Incomplete annual diabetes care | 0.68 (0.31–1.51) |
| Had never taken a course or class on diabetes self-management | 0.71 (0.32–1.61) |
| Did not know the number of HbA1c tests received in past year or did not know what an HbA1c test is | 1.32 (0.45–3.91) |
| Did not see provider about diabetes in past year | 0.84 (0.29–2.41) |
| Never examines feet | 1.27 (0.53–3.07) |
| Diabetes-related retinopathy | 1.08 (0.54–2.15) |