The overall purpose of this study is to describe factors that contribute to risk for poor health outcomes in a low-income population receiving care for diabetes in primary care settings. Multidimensional factors present at time of initial treatment are studied to index the vulnerable diabetic patient’s risk for poor outcomes. Iezzoni’s (1997) effectiveness model informed the identification of the broad dimensions of risk and outcomes studied. Within each dimension, risk and outcome variables with documented relevance to diabetes care management and/or vulnerability were selected for testing. Data were collected by audit of a sample of charts (N=500) randomly selected from an ethnically diverse low-income population obtaining care for diabetes in an urban health system in the Midwest. Access to care, utilization, risk behavior, self-care behavior, demographic, social support, clinical/disease indicator and provider practice pattern data were collected for a one year period starting at the time of initial treatment for diabetes. Multivariate predictive modeling approaches were used to identify risk factors with the greatest impact on the development of untoward events, secondary complications and high cost utilization of the health care system. Findings from this study will be applied to development of a risk-sensitive model of diabetes care that specifies care guidelines of varying levels of resource intensity for patients at low, moderate and high risk for destabilization.
Learning Objectives: 1. Describe multidimensional factors that place low-income diabetics at risk for poor health outcomes. 2. List five risk factors linked to poor health outcomes for low-income individuals with diabetes. 3. Articulate the process of comprehensive risk assessment in low-income individuals
Keywords: Diabetes, Risk Assessment
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Michigan State University, East Lansing MI
St. Mary's Health System, Grand Rapids MI
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.