[Outpatient care of patients with diabetes mellitus in 2001. Analysis of a health insurance sample of the AOK in Hesse/KV in Hesse]

Dtsch Med Wochenschr. 2003 Dec 12;128(50):2638-43. doi: 10.1055/s-2003-45484.
[Article in German]

Abstract

Aim: Aim of this retrospective case-control study was to assess the quality of out-patient care in patients with diabetes mellitus by analysing health insurance data from a large cohort of members of a regional statutory health insurance fund in Hesse.

Methods: The study was carried out in the 'Versichertenstichprobe AOK Hessen/KV Hessen', a 18.75% random sample of the AOK Hesse, for the year 2001 corresponding to 306,736 subjects and 26,972 diabetics. All medical services and prescriptions provided by primary-care physicians were documented.

Results: Compared to an age- and sex-matched control group patients with diabetes received more out-patient medical services (diabetics: 126 +/- 0.8, controls: 76 +/- 0.4 per year, p < 0.0001) and more prescriptions (diabetics: 39.9 +/- 0.3, controls: 20.0 +/- 0.3 per year, p < 0.0001) in 2001. HbA (1c) measurements were performed in 69.5% of the insulin-treated patients, in 64.3% of the patients under monotherapy with oral hypoglycaemic agents and in 41.1% of the patients under dietary treatment. 78.1% of the insulin-treated patients, 12.0% of those under oral hypoglycaemic agents and 2.0% of patients under dietary treatment received prescriptions for material for blood glucose self-monitoring. In contrast, a retinal examination was performed in only 45.8%, 31.1% and 22.5% of the patients in the three treatment groups throughout the year. The respective figures for screening for microalbuminuria in the three treatment groups were 12.7%, 7.1% and 3.6%.

Conclusions: The results of this retrospective analysis suggest that the out-patient medical care of subjects with diabetes is in some respect unsatisfactory and does not comply with the accepted recommendations for appropriate diabetes care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Child
  • Cohort Studies
  • Combined Modality Therapy / statistics & numerical data
  • Diabetes Mellitus / diet therapy
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / therapy*
  • Diet, Diabetic*
  • Female
  • Germany
  • Glycated Hemoglobin / analogs & derivatives*
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use
  • Insurance, Health / statistics & numerical data*
  • Male
  • Middle Aged
  • Outpatients / statistics & numerical data*
  • Quality of Health Care / standards*
  • Quality of Health Care / statistics & numerical data
  • Retrospective Studies

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • glucosylated hemoglobin A