Research PaperQuality of diabetes care for adults with developmental disabilities
Section snippets
Methods
We conducted a retrospective cohort analysis for quality of care measures among adult (ages 18 to 65 years) persons with developmental disabilities who had diabetes and who were enrolled in the Kansas Medicaid Aged, Blind and Disabled (ABD) Program. Kansas Medicaid provides long-term care, inpatient, outpatient, pharmacy, and hospice coverage to adults with disabilities who qualify for Supplemental Security Income (SSI), are Medically Needy, are qualified Medicare beneficiaries, or are severely
Results
There were 5,930 persons with developmental disabilities and continuous enrollment in the Kansas Medicaid program during the 12-month monitoring period. The prevalence of diabetes was 11.2% (666 persons identified as having diabetes based on prior claims). Their mean age was 43.1 years with over half of the cohort between 31 and 50 years of age (Table 2): the mean age of those with diabetes was approximately 8 years older than the overall cohort. The majority was Caucasian (86.5%), and males
Discussion
Adults with developmental disabilities and diabetes who were enrolled in the Kansas Medicaid ABD program were screened less frequently for key quality indicators of diabetes care in the course of 12 months than rates reported for overall Medicaid programs. HbA1c/glucose was assessed in just over 50% of the study population, while NCQA data indicate a much higher rate of strictly HbA1c monitoring in those with commercial and Medicare health plans (>88%), and among all Medicaid enrollees (77%).
Conclusions
The results presented provide an important insight into the utilization of quality of care measures for diabetes among persons with developmental disabilities enrolled in Kansas Medicaid. Collectively these data suggest markedly lower rates of quality of diabetes care measures in those with developmental disabilities compared with published national rates. These findings generate a number of concerns regarding the health of this population with potential economic implications. The basis of
References (23)
The state of health care quality
(2008)Quality of care in Medicaid managed care and commercial health plans
JAMA
(2007)Quality measurement in Medicaid managed care and fee-for-service: the New York State experience
Am J Med Qual
(2006)Helping families with needed care: Medicaid's critical role for Americans with disabilities
(2008)- KFF. Kaiser State Health Facts, FY 2006. Available at:...
Health conditions among women with a disability
J Womens Health (Larchmt)
(2007)Variation in health conditions among groups of adults with disabilities in primary care
J Commun Health
(2006)- et al.
Health disparities among adults with developmental disabilities, adults with other disabilities, and adults not reporting disability in North Carolina
Public Health Rep
(2004) - et al.
Medical disorders of adults with mental retardation: a population study
Am J Ment Retard
(1995) Healthy People 2010
Closing the gap: a national blueprint to improve the health of persons with mental retardation: report of the Surgeon General's Conference on Health Disparities and Mental Retardation
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Financial disclosure: Aside from the federal funding from CMS provided through a subcontract between our institution and KHPA, none of the authors have any potential conflicts of interest, financial or otherwise, to report. This project was funded by a Centers for Medicare and Medicaid (CMS) Medicaid Transformation Grant provided to KHPA with a subcontract to KUMC: Health Promotion for Persons with Disabilities. The results do not necessarily reflect the opinions or policy of KHPA or any state or federal governmental agency.