Chronic Disease Care for Beneficiaries wiwth Multiple Chronic Conditions

Dr. Marshall McBean, Debra Caldwell, and Dr. Kyoungrae Jung from the University of Minnesota will present CCW findings related to Medicare Research and Demonstration (MRAD) Task Order #1, “Monitoring Chronic Disease Care and Outcomes Among Elderly Medicare Beneficiaries with Multiple Chronic Diseases.” The study looks at the impact on elderly fee-for service Medicare beneficiaries with diabetes of having one or two specific additional chronic diseases: COPD and/or depression. The outcomes of interest are the receipt of recommended diabetes care and preventive services among those who have diabetes, diabetes + COPD, diabetes + depression, or diabetes + COPD + depression. For diabetes care, the rates of HbA1c testing, lipid measurement and eye exams were examined, and for preventive care measures, influenza vaccination, mammography and prostate specific antigen (PSA) screening were examined. This session will focus on presenting the results of HbA1C testing. For this measure, age-adjusted rates and multivariate analyses controlling for socio-demographic, health status, and health services factors showed a large, negative impact of having COPD or COPD + depression in addition to diabetes on the rate of HbA1c testing. Age-adjusted HbA1c rates among those with diabetes + depression were lower than the rates among those with only diabetes; however, this difference disappeared in the full multivariate analysis. Dr. McBean and Ms. Caldwell will also share their experiences working with CCW Medicare data.