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Research Highlights
VA Diabetes Care Better than Commercial Managed Care
August 22, 2004
Type 2 diabetes affects about 17 million people and contributes to more than 200,000 deaths each year in the United States. However, despite many cost-effective treatments diabetes care remains suboptimal. More than 800,000 patients with diabetes receive care through the VA healthcare system. This is the first study to compare the quality of diabetes care among patients in the VA and commercial managed care (CMC) organizations using comparable sampling, data collection, and quality measurement methods. Investigators in this study conducted a cross-sectional patient survey or interview, along with a retrospective review of medical records for patients who received care at one of five VA medical centers (N=1285), or from one of eight CMC organizations (N=6920). VA and CMC facilities were in five matched geographic regions. Quality of care measures were compared for 7 diabetes processes of care (e.g., hemoglobin A1c test and eye exam), 3 diabetes intermediate outcomes (e.g., blood pressure and cholesterol control), and 4 dimensions of satisfaction (e.g., getting needed care, how well doctors communicate). Findings from this study show that VA patients had better scores than CMC patients on all assessed quality of care measures, including better annual hemoglobin A1C testing (93% for VA vs. 83% for CMC), aspirin counseling (75% vs. 49%), eye exams (91% vs. 75%), and foot exams (98% vs. 84%). VA patients also had better LDL control and were slightly more satisfied with the overall quality of diabetes care.
Kerr E, Gerzoff R, Krein S, Selby J, Piette J, et al. "A Comparison of Diabetes Care Quality in the Veterans Healthcare System and Commercial Managed Care." Annals of Internal Medicine 2004;141(4)272-281.
* This study was partly funded by HSR&D, in collaboration with the Centers for Disease Control and Prevention and the National Institute of Diabetes, Digestive, and Kidney Diseases.
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