Table 3.
Health status and service utilization in fiscal years (FY) 2011 and 2013 by utilization of education, case management, and advanced practice pharmacy (ECP) services in FY2012. Bivariate associations.a
| All adults with diabetes | Adults with diabetes absent CVD | Adults with diabetes and CVD | |||||||
|---|---|---|---|---|---|---|---|---|---|
| ECP non-users | ECP users | ECP non-users | ECP users | ECP non-users | ECP users | ||||
| All adults with diabetes | 16,855 | 11,723 | 12,733 | 8,044 | 4,122 | 3,679 | |||
| Clinical Measures | |||||||||
| High SBP ≥ 140 mmHgb | |||||||||
| FY 2011 | 23.6% | 22.6% | 21.8% | 20.4% | 29.0% | 27.5% | |||
| FY 2013 | 25.9% | 23.8% | ** | 24.4% | 21.5% | *** | 30.7% | 28.7% | |
| Difference | 2.4% | 1.2% | 2.6% | 1.2% | 1.7% | 1.2% | |||
| High hemoglobin A1c ≥ 8%b | |||||||||
| FY 2011 | 42.5% | 44.5% | * | 43.2% | 45.4% | * | 40.4% | 42.5% | |
| FY 2013 | 46.3% | 46.7% | 47.2% | 47.5% | 43.8% | 45.0% | |||
| Difference | 3.9% | 2.2% | * | 4.0% | 2.1% | * | 3.4% | 2.4% | |
| High LDL cholesterol ≥ 100 mg/dLb | |||||||||
| FY 2011 | 44.1% | 38.5% | *** | 46.9% | 42.0% | *** | 36.2% | 31.5% | ** |
| FY 2013 | 38.8% | 34.0% | *** | 41.3% | 37.6% | *** | 31.8% | 26.7% | ** |
| Difference | −5.3% | −4.6% | −5.6% | −4.5% | −4.3% | −4.7% | |||
| Onset of CVD 2013 | 7.3% | 9.1% | *** | ||||||
| Onset of ESRD 2013 | 0.5% | 0.4% | 0.2% | 0.1% | 1.5% | 1.1% | |||
| Hospital service use | |||||||||
| Average number of I/T ED visits | |||||||||
| FY 2011 | 0.79 | 0.78 | 0.69 | 0.62 | ** | 1.10 | 1.12 | ||
| FY 2013 | 0.82 | 0.75 | *** | 0.75 | 0.64 | *** | 1.03 | 0.98 | |
| Difference | 0.03 | −0.03 | ** | 0.07 | 0.02 | * | −0.06 | −0.14 | |
| Percent with 1 or more hospitalizations | |||||||||
| FY 2011 | 8.8% | 10.3% | *** | 5.5% | 5.7% | 19.9% | 21.2% | ||
| FY 2013 | 8.6% | 8.9% | 6.8% | 6.5% | 14.8% | 14.5% | |||
| Difference | −0.2% | −1.4% | ** | 1.3% | 0.8% | −5.2% | −6.7% | ||
| Average number of inpatient days | |||||||||
| FY 2011 | 0.49 | 0.61 | ** | 0.23 | 0.25 | 1.32 | 1.46 | ||
| FY 2013 | 0.62 | 0.63 | 0.41 | 0.36 | 1.28 | 1.27 | |||
| Difference | 0.13 | 0.02 | 0.18 | 0.11 | 0.04 | −0.19 | |||
| Percent with 1 or more I/T potentially preventable hospitalizations | |||||||||
| FY 2011 | 2.1% | 2.6% | ** | 1.1% | 1.3% | 5.0% | 5.5% | ||
| FY 2013 | 2.3% | 2.3% | 1.5% | 1.4% | 4.7% | 4.2% | |||
| Difference | 0.2% | −0.4% | * | 0.4% | 0.1% | −0.4% | −1.3% | ||
FY: fiscal year; CVD: cardiovascular disease; SBP: systolic blood pressure; LDL: low-density lipoprotein; ESRD: end-stage renal disease; I/T: Indian Health Service and Tribal
*
p < 0.05;
**
p < 0.01;
***
p < 0.001
a
Associations between values for ECP users and non-users during FY2011, FY2013, and the difference between the 2 years.
b
These clinical measures were assessed for adults in the study population who had both FY2011 and FY2013 data.