Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108191

Usha Sambamoorthi, PhD¹, Patricia A. Findley, DrPH, MSW², Miriam Maney, MA¹, Leonard Pogach, MD, MBA³, and Thomas W. Findley, MD, PHD¹. (1) Health Care Knowledge and Management, East Orange VA Medical Center, 385 Tremont Avenue, Mail Stop 129, East Orange, NJ 07018, 973-676-1000 x2713, tfindley@njneuromed.org, (2) Program for Disability Research, Rutgers University, 303 George Street, Suite 405, New Brunswick, NJ 08901, (3) Diabetes Research Group, New Jersey East Orange VA Hospital, 385 Tremont, VAMC #129, East Orange, NJ 07018

Objective: For veteran clinical users (VHA) with diabetes, compare patterns of glycemic and blood pressure (BP) control among patients with (SCI/DM) and without spinal cord injury (NO SCI/DM).

Study Design: Retrospective analysis of VHA patient treatment files veteran clinical users with diabetes. Poor glycemic and BP control were defined as levels of HbA1c greater than 9 and BP values over 140/90, respectively. Chi-square tests and logistic regressions were used to assess group differences between diabetic VHA patients with and without SCI.

Population Studied: 5,458 patients with SCI/DM and 561,100 patients with NO SCI/DM.

Principal Findings: Among patients with completed HbA1c tests and BP tests, we found significant differences in intermediate outcomes between the two groups. Nearly 8% of those with SCI/DM and 12% of those with NO SCI/DM had three consecutive BP values over 140/90. Veterans with SCI/DM group were less likely to have poor glycemic control (13%) compared to the NO SCI/DM group (17%) using a threshold HbA1c value of greater than 9.

Conclusion: VHA system individuals with SCI and chronic illness are less likely to have poorer intermediate outcomes of care than able-bodied with chronic illness.

Implications for Policy, Delivery or Practice: These results suggest that integrated health care systems are able to meet the needs of individuals with disabilities; this contrasts with findings by others that individuals with disabilities receive less preventive care. Other health care systems could provide high quality health care to individuals with disabilities with chronic illness by implementing similar comprehensive and coordinated care.

Learning Objectives:

• • The learner will (a) recognize the usefulness of administrative data to identify patients with diabetes and spinal cord injury in the veterans health care system, (b) understand the relationship between intermediate outcomes of diabetes care and disability, (c) evaluate the impact of integrated health systems on chronic illness care among individuals with disability.

Keywords: Special Populations, Disease Management

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.