Racial Disparities and the Impact of Diabetes Registry on Quality of Care among Commercially-insured

Introduction: The National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set (HEDIS) specifications are commonly used by health plans to measure quality of care. Our objective was to estimate the burden of diabetes and racial disparities in diabetes screening among commercially-insured members who have a primary-care-physician (PCP) relationship.

Materials/Methods: We applied 2010 HEDIS specifications to 2009 paid claims and identified 63,346 PCP attributed diabetic members whose race information was obtained via market research data. Diabetes prevalence and rates for three diabetes-related quality indicators were examined by race and compared for members whose PCP's practices had registries verses whose did not.

Results: The prevalence of diabetes among commercial members with a PCP relationship was 6.4%; with the highest prevalence among Blacks (11.3%). Members whose PCP practice had diabetes registries had higher screening rates of HbA1c (80.6%-85.7% vs. 75.8%-82.9%) for all race categories. Overall improvement in quality of care for PCPs with a registry ranged from 0.9% to 3.5% for HBA1c, nephropathy, and LDL-C screenings. The racial disparity in HbA1c rates in particular was observed to be less between black and white members with a registry (4.0%) than those without registries (7.0%).

Discussion: The prevalence of diabetes in this commercial population mirrors that of the general population. Diabetes registries may improve the delivery of evidence-based care across all demographic segments and may help reduce racial disparities in evidence-based care measures particularly in regards to HbA1c testing.