[Non-insulin treated diabetes: relationship between disease management and quality of care. The Entred study, 2001].

Abstract

INTRODUCTION:

We studied the relationship between 100% medical fee coverage for chronic disease and quality of care in people with type 2 diabetes treated with oral hypoglycaemic agents (OHA) only, in France.

METHODS:

For the Entred study, 10,000 adults who received reimbursements for a delivery of OHA or insulin were randomly sampled from the database of the major national medical insurance system in 2001. For these 10,000 people, we extracted all medical consumption from the 2001 database and mailed a medical questionnaire; another questionnaire was mailed to their medical provider. We restricted the analysis to people with type 2 diabetes, treated with OHA only, with no annual visit to an endocrinologist (n = 1167), and to a sub-group with no complication reported by their medical provider (n = 525).

RESULTS:

71% of people benefited from a waiver of co-payment due to a chronic disease (100% medical fee coverage for a list of 30 diseases including diabetes). People with 100% coverage were more likely to be women, older, with a longer duration of the disease, more often on several OHA and a drug for cardiovascular disease, and had a higher level of HbA1c. In multivariate analyses, 100% fee coverage was linked with a higher frequency of three HbA1c measurements (OR = 2,5 [1,6-4,0]), one electrocardiogram (1,9 [1,2-3,1]) and one podiatric visit (2,2 [1,1-4,3]) in 2001 in people without complications. No association was found with one measurement of albuminuria, creatininemia, lipids, and ophtalmological, dental or dietitian visit.

CONCLUSIONS:

In 2001, a significant relationship was found between 100% medical fee coverage on a better quality of care for people with diabetes on OHA at an early stage of the disease. Several explanations are further discussed.

• Authors: Anne Fagot-Campagna, Isabelle Romon, Nathalie Poutignat, Juliette Bloch, Comité Scientifique d'Entred
• Journal: La Revue du praticien (Rev Prat) Vol. 57 Issue 20 Pg. 2209-16 (Dec 31 2007) ISSN: 0035-2640 [Print] France
• Vernacular Title: Diabète non insulino-traité: lien entre l'existence d'une prise en charge pour affection de longue durée et la qualité du suivi médical. Données entred 2001.
• PMID: 18320738 (Publication Type: English Abstract, Journal Article)

Chemical References

• Hypoglycemic Agents

Topics

• Aged
• Diabetes Complications (epidemiology, prevention & control)
• Diabetes Mellitus, Type 2 (drug therapy, epidemiology)
• Disease Management
• Female
• France (epidemiology)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Male
• Quality Assurance, Health Care