Patient characteristics and process of care measures as predictors of glycemic control

• Objective: To assess whether patient characteristics and process of care measures predict glycemic control among patients with diabetes. • Methods: We used ICD-9-CM codes to identify patients with diabetes seen in a university-based family medicine teaching practice during 2006. We identified a total of 1398 patients who had made 7982 patient visits. We collected data on patient characteristics, processes of care received, and whether patients obtained an A1C of < 7%, indicating glycemic control. We created a composite process measure consisting of receipt of at least 2 hemoglobin A1C measurements, at least 1 low-density lipoprotein cholesterol measurement, and at least 1 blood pressure (BP) measurement in the study year. • Results: Having Medicare insurance (odds ratio [OR], 2.01 [confidence interval {CI}, 1.39-2.89]), being female (OR, 1.51 [CI, 1.14-2.00]) and not receiving glycemic medications were associated with having glycemic control. The composite process measure was not associated with obtainment of glycemic control. • Conclusion: Our findings indicate that having Medicare insurance and being female were associated with better A1C control. Further study is needed to develop measures that predict a patient's ability to achieve recommended A1C levels. Copyright 2009 by Turner White Communications Inc. All rights reserved.

Duke Scholars

Author Elizabeth Strachan Erickson Pediatrics, General Pediatrics and Adolescent Health