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Titolo:
Continuity and quality of care for children with diabetes who are covered by medicaid
Autore:
Christakis, DA; Feudtner, C; Pihoker, C; Connell, FA;
Indirizzi:
Univ Washington, Inst Child Hlth, Dept Pediat, Seattle, WA 98103 USA Univ Washington Seattle WA USA 98103 , Dept Pediat, Seattle, WA 98103 USA Hlth Serv, Seattle, WA USA Hlth Serv Seattle WA USAHlth Serv, Seattle, WA USA Inst Child Hlth, Seattle, WA USA Inst Child Hlth Seattle WA USAInst Child Hlth, Seattle, WA USA Childrens Hosp, Div Endocrinol, Seattle, WA USA Childrens Hosp Seattle WAUSA rens Hosp, Div Endocrinol, Seattle, WA USA
Titolo Testata:
AMBULATORY PEDIATRICS
fascicolo: 2, volume: 1, anno: 2001,
pagine: 99 - 103
SICI:
1530-1567(200103/04)1:2<99:CAQOCF>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
GREATER CONTINUITY; MELLITUS; ASSOCIATION; MORTALITY; PEOPLE; COUNTY; BLACK; IDDM;
Keywords:
continuity of patient care; diabetes; diabetic ketoacidosis; pediatrics;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Christakis, DA Univ Washington, Inst Child Hlth, Dept Pediat, 146 N Canal St,Suite 300, Seattle, WA 98103 USA Univ Washington 146 N Canal St,Suite 300 Seattle WA USA 98103
Citazione:
D.A. Christakis et al., "Continuity and quality of care for children with diabetes who are covered by medicaid", AMBU PEDIAT, 1(2), 2001, pp. 99-103

Abstract

Background.- Poor and minority children with Type I diabetes mellitus are at increased risk of severe adverse outcomes as a result of their disease. However, little is known about the quality of care that these children receive and which factors are associated with better quality of care. Objectives.- Our objectives were as follows: 1) to describe the utilization of services associated with quality of care for children with Type 1 diabetes mellitus who are covered by Medicaid and 2) to test the hypothesis that increased continuity of primary care is associated with better care for these children. Design.- Retrospective cohort study. Methods.- Washington State Medicaid claims data for 1997 were used to determine what proportion of children with diabetes had 1) an inpatient or outpatient diagnosis of diabetic ketoacidosis (DKA), 2) a glycosylated hemoglobin (HgAlc) level that had been checked, 3) a retinal examination, and 4) thyroid function studies. Continuity of care was quantified using a pre-established index. Results.- Two hundred fifty-two eligible patients were identified. During the observation year, 20% had an outpatient diagnosis of DKA, 6% were admitted with DKA, 43% visited an ophthalmologist, 54% had their HgAlc checked, and 21% had their thyroid function assessed. Children with high continuity of care were less likely to have DKA as an outpatient (0.30 [0.13-0.71]). Children with medium continuity of care and high continuity of care were less likely to be hospitalized for DKA (0.22 [0.05-0.87] and 0.14 [0.03-0.67],respectively). For preventive services utilization, high continuity of care was associated only with an increased likelihood of visiting an ophthalmologist (2.80 [1.08-3.88]). Conclusions.- The quality of care for Medicaid children with diabetes can be substantially improved. Low continuity of primary care is an identifiable risk factor for DKA.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/12/19 alle ore 11:37:01