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National Healthcare Disparities Report, 2003

Effectiveness of Care: Diabetes

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Management of Diabetes
Adults with diabetes who had a hemoglobin A1c measurement at least once in the past year
Adults with diabetes who had a lipid profile in the past 2 years
Adults with diabetes who had a retinal eye examination in the past year
Adults with diabetes who had a foot examination in the past year
Adults with diabetes who had an influenza immunization in the past year
Hospital admissions for uncontrolled diabetes per 100,000 population
Hospital admissions for short-term complications of diabetes per 100,000 population
Hospital admissions for long-term complications of diabetes per 100,000 population
Hospital admissions for lower extremity amputations in patients with diabetes per 100,000 population


Management of Diabetes

Measure Title

Percent of adults with diabetes who had a hemoglobin A1c measurement at least once in the past year.

Healthy People 2010, measure 5-12.

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

Tables

Percent of adults with diabetes who had a hemoglobin A1c measurement at least once in the past year, United States, 2000, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who answered the Diabetes Care Supplement (DCS) question: "During 2000, how many times did a doctor, nurse, or other health professional check for glycosylated hemoglobin or 'hemoglobin A-one-C'?"

Numerator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who indicated they had a hemoglobin A1c test at least once in 2000.

Comments

Nonresponses and "Don't know" responses to the DCS question were excluded from the analysis.

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Management of Diabetes

Measure Title

Percent of adults with diabetes who had a lipid profile in the past two years.

Measure Source

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

Tables

Percent of adults with diabetes who had a lipid profile in the past two years, United States, 2000, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who answered the Diabetes Care Supplement (DCS) question: "About how long has it been since you had your blood cholesterol checked by a doctor or other health professional?"

Numerator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who answered "Within the past two years" to the DCS question.

Comments

Nonresponses and "Don't know" responses to the DCS question were excluded from the analysis.

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Management of Diabetes

Measure Title

Percent of adults with diabetes who had a retinal eye examination in the past year.

Measure Source

Healthy People 2010, measure 5-13.

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

Tables

Percent of adults with diabetes who had a retinal eye examination in the past year, United States, 2000, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who answered the Diabetes Care Supplement (DCS) question: "When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to light.

Numerator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who indicated they had at least one retinal eye examination in 2000 or early 2001 (depending on Panel).

Comments

Nonresponses and "Don't know" responses to the DCS question were excluded from the analysis.

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Management of Diabetes

Measure Title

Percent of adults with diabetes who had a foot examination in the past year.

Measure Source

Healthy People 2010, measure 5-14.

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

Tables

Percent of adults with diabetes who had a foot examination in the past year, United States, 2000, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who answered the Diabetes Care Supplement (DCS) question: "During 2000, how many times did a health professional check your feet for any sores or irritations?"

Numerator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who indicated they had a foot examination one or more times in 2000.

Comments

Nonresponses and "Don't know" responses to the DCS question were excluded from the analysis.

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Management of Diabetes

Measure Title

Percent of adults with diabetes who had an influenza immunization in the past year.

Measure Source

National Alliance for Diabetes Quality Improvement, National Quality Forum, 2002.

Tables

Percent of adults with diabetes who had an influenza immunization in the past year, United States, 2000, by

  • Race
  • Ethnicity
  • Family income
  • Education

Data Source

Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), Medical Expenditure Panel Survey.

Denominator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who answered the Diabetes Care Supplement (DCS) question: "How long since last flu shot?"

Numerator

Adult U.S. population (18 years of age and older, civilian, noninstitutionalized) with diabetes who indicated they had an influenza immunization within 2000.

Comments

Nonresponses and "Don't know" responses to the DCS question were excluded from the analysis.

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Management of Diabetes

Measure Title

Hospital admissions for uncontrolled diabetes per 100,000 population.

Measure Source

Healthy People 2010, measure 1-9c.

Tables

Adult admissions for uncontrolled diabetes without complication (excluding obstetric and neonatal admissions and transfers from other institutions) per 100,000 population age 18 and older, 2000, by

  • Race

Data Source

Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases, 16-State database.

Denominator

Population in the 16 States age 18 and over.

Numerator

Adult non-maternal discharges age 18 and over with principal diagnosis of uncontrolled diabetes, without mention of a short-term (ketoacidosis, hyperosmolarity, coma) or long-term complication (renal, eye, neurological, circulatory, other unspecified). Transfers from other institutions are excluded.

Comments

Rates are adjusted by age and sex, using the year 2000 population age 18 and over in the 16 States as the standard population.

The 16 States are Arizona, California, Connecticut, Florida, Georgia, Kansas, Massachusetts, Maryland, Missouri, New Jersey, New York, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

This table was created using version 2.1 of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 14 in the AHRQ Prevention Quality Indicators software documentation.

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Management of Diabetes

Measure Title

Hospital admissions for short-term complications of diabetes per 100,000 population.

Measure Source

AHRQ Prevention Quality Indicators.

Tables

Adult admissions for diabetes with short-term complications (excluding obstetric admissions and transfers from other institutions) per 100,000 population age 18 and older, 2000, by

  • Race

Data Source

Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases, 16-State database.

Denominator

Population in the 16 States age 18 and over.

Numerator

Adult non-maternal discharges age 18 and over with a principal diagnosis of diabetes complications: diabetic ketoacidosis, diabetes with hyperosmolar, coma. Transfers from other institutions are excluded.

Comments

Rates are adjusted by age and sex, using the year 2000 population age 18 and over in the 16 States as the standard population.

The 16 States are Arizona, California, Connecticut, Florida, Georgia, Kansas, Massachusetts, Maryland, Missouri, New Jersey, New York, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

This table was created using version 2.1 of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 1 in the AHRQ Prevention Quality Indicators software documentation

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Management of Diabetes

Measure Title

Hospital admissions for long-term complications of diabetes per 100,000 population.

Measure Source

AHRQ Prevention Quality Indicators.

Tables

Adult admissions for diabetes with long-term complications (excluding obstetric admissions and transfers from other institutions) per 100,000 population age 18 and older, 2000 by

  • Race

Data Source

Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, State Inpatient Databases, 16-State database.

Denominator

Population in the 16 States age 18 and over.

Numerator

Adult non-maternal discharges age 18 and over with a diagnosis of diabetes and any diagnosis indicating long-term complications including: retinopathy; microvascular disease (including coronary heart disease, cerebrovascular disease, and peripheral vascular disease, leading to amputation); sensory neuropathy; and impaired renal function. Transfers from other institutions are excluded.

Comments

Rates are adjusted by age and sex, using the year 2000 population age 18 and over in the 16 States as the standard population.

The 16 States are Arizona, California, Connecticut, Florida, Georgia, Kansas, Massachusetts, Maryland, Missouri, New Jersey, New York, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

This table was created using version 2.1 of the AHRQ Prevention Quality Indicators software. This measure is referred to as indicator 3 in the AHRQ Prevention Quality Indicators software documentation.

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Management of Diabetes

Measure Title

Hospital admissions for lower extremity amputations in patients with diabetes per 100,000 population.

Measure Source

Healthy People 2010, measure 5-10.

Tables

Lower extremity amputations in persons with diabetes per 1,000 population, United States, 2000, by

  • Race

Data Source

Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Discharge Survey, National Health Interview Survey.

Denominator

Number of persons in the NHIS population who report that they have ever been diagnosed with diabetes.

Numerator

Number of hospital discharges among U.S. civilian persons with diabetes (ICD-9-CM code 250) as any listed diagnosis and amputation of the lower limb (ICD-9-CM procedure code 84.1) as any listed procedure.

Comments

The numerator and denominator of this measure refer to slightly different populations. The numerator includes the U.S. civilian population; the denominator includes only the U.S. civilian, noninstitutionalized population. The numerator is obtained from the National Hospital Discharge System (NHDS) and uses any mention ICD-9-CM procedure code 84.1 to define amputation of the lower limb and ICD-9-CM code 250 as any listed diagnosis to identify persons with diabetes. Amputations due to trauma are not included. Adults are considered to have diabetes if they respond "yes" to either of the two questions listed in the DENOMINATOR section of objective 5-3. Those who respond "borderline" are not included. Women who report that the only time they have been diagnosed with diabetes was during pregnancy (gestational diabetes) are also excluded. Children are considered to have diabetes if the adult proxy respondent reports that they have ever been told by a doctor that the child has diabetes. Data are age adjusted to the 2000 standard population using the age groups under 65 years, 65-74, and 75 years and over. Age-adjusted rates are weighted sums of age-specific rates.

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2003 National Healthcare Disparities Report

 

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