Table 5.
Patient outcomes during fiscal year (FY) 2013 associated with level of education, case management, and advanced practice pharmacy (ECP) service use during FY2012. Propensity score model, based on an ordered logistic regression, using inverse probability weighting.a
| All adults with diabetes | Adults with diabetes absent CVD | Adults with diabetes and CVD | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient outcome | 1–2 ECP visits (vs 0 visits) | 3+ ECP visits (vs 0 visits) | 3+ ECP visits (vs 1–2 visits) | 1–2 ECP visits (vs 0 visits) | 3+ ECP visits (vs 0 visits) | 3+ ECP visits (vs 1–2 visits) | 1–2 ECP visits (vs 0 visits) | 3+ ECP visits (vs 0 visits) | 3+ ECP visits (vs 1–2 visits) | ||||||||||||||||||
| Health status: Clinical measures | |||||||||||||||||||||||||||
| High systolic blood pressure (≥140 mmHg)b | |||||||||||||||||||||||||||
| Average Treatment Effect | −1.8% | * | −4.8% | *** | −3.0% | * | −2.4% | ** | −4.6% | ** | −2.2% | −0.4% | −3.0% | −2.6% | |||||||||||||
| Odds Ratio | 0.89 | * | 0.74 | *** | 0.82 | * | 0.85 | ** | 0.73 | ** | 0.86 | 0.98 | 0.85 | 0.87 | |||||||||||||
| OR Confidence Interval | (0.82, 0.97) | (0.63, 0.86) | (0.70, 0.97) | (0.77, 0.95) | (0.60, 0.89) | (0.69, 1.06) | (0.84, 1.15) | (0.68, 1.07) | (0.67, 1.12) | ||||||||||||||||||
| High A1c (≥8%)b | |||||||||||||||||||||||||||
| Average Treatment Effect | 1.7% | * | 0.4% | −1.3% | 1.8% | −1.5% | −3.3% | 0.9% | 4.5% | * | 3.6% | ||||||||||||||||
| Odds Ratio | 1.09 | * | 1.02 | 0.93 | 1.10 | 0.93 | 0.84 | 1.05 | 1.28 | * | 1.22 | ||||||||||||||||
| OR Confidence Interval | (1.004, 1.186) | (0.89, 1.17) | (0.80, 1.09) | (1.00, 1.21) | (0.78, 1.10) | (0.70, 1.02) | (0.89, 1.24) | (1.02, 1.61) | (0.94, 1.57) | ||||||||||||||||||
| High LDL cholesterol (≥100 mg/dL)b | |||||||||||||||||||||||||||
| Average Treatment Effect | −1.4% | −5.1% | *** | −3.7% | * | −0.7% | −6.3% | *** | −5.6% | ** | −3.7% | * | −2.5% | 1.1% | |||||||||||||
| Odds Ratio | 0.93 | 0.77 | *** | 0.83 | * | 0.97 | 0.73 | *** | 0.75 | ** | 0.82 | * | 0.87 | 1.07 | |||||||||||||
| OR Confidence Interval | (0.86, 0.14) | (0.62, 0.00) | (0.72, 0.04) | (0.87, 1.07) | (0.61, 0.87) | (0.62, 0.91) | (0.68, 0.97) | (0.68, 1.11) | (0.81, 1.40) | ||||||||||||||||||
| Health status: Onset of comorbidities | |||||||||||||||||||||||||||
| CVDb,c | |||||||||||||||||||||||||||
| Average Treatment Effect | −0.6% | −1.5% | * | −1.0% | |||||||||||||||||||||||
| Odds Ratio | 0.92 | 0.79 | * | 0.85 | |||||||||||||||||||||||
| OR Confidence Interval | (0.80, 1.05) | (0.63, 0.99) | (0.67, 1.09) | ||||||||||||||||||||||||
| ESRDb,c | |||||||||||||||||||||||||||
| Average Treatment Effect | −0.8% | * | −0.6% | 0.2% | |||||||||||||||||||||||
| Odds Ratio | 0.55 | * | 0.64 | 1.16 | |||||||||||||||||||||||
| OR Confidence Interval | (0.33, 0.92) | (0.32, 1.29) | (0.55, 2.48) | ||||||||||||||||||||||||
| Hospital service utilization during FY2013 | |||||||||||||||||||||||||||
| Emergency visitsd | |||||||||||||||||||||||||||
| Average Treatment Effect | −0.08 | *** | −0.11 | ** | −0.02 | −0.08 | ** | −0.13 | ** | −0.05 | −0.14 | ** | −0.05 | 0.08 | |||||||||||||
| ATE Confidence Interval | (−0.13, −0.04) | (−0.17, −0.04) | (−0.09, 0.05) | (−0.12, −0.04) | (−0.19, −0.06) | (−0.12, 0.03) | (−0.24, −0.04) | (−0.19, 0.08) | (−0.06, 0.23) | ||||||||||||||||||
| 1 or more hospitalizationsb | |||||||||||||||||||||||||||
| Average Treatment Effect | −1.3% | ** | −1.8% | ** | −0.6% | −1.2% | ** | −1.8% | * | −0.6% | −2.8% | * | −3.1% | * | −0.3% | ||||||||||||
| Odds Ratio | 0.82 | ** | 0.75 | ** | 0.91 | 0.80 | ** | 0.70 | * | 0.88 | 0.75 | * | 0.72 | * | 0.97 | ||||||||||||
| OR Confidence Interval | (0.72, 0.93) | (0.61, 0.91) | (0.73, 1.13) | (0.68, 0.94) | (0.53, 0.93) | (0.65, 1.19) | (0.60, 0.93) | (0.53, 0.98) | (0.69, 1.37) | ||||||||||||||||||
| 1 or more potentially preventable hospitalizationsb | |||||||||||||||||||||||||||
| Average Treatment Effect | −0.3% | −0.9% | ** | −0.6% | * | −0.3% | −0.5% | * | −0.2% | −0.8% | −2.1% | ** | −1.3% | * | |||||||||||||
| Odds Ratio | 0.86 | 0.62 | ** | 0.72 | * | 0.80 | 0.65 | * | 0.81 | 0.81 | 0.54 | ** | 0.667 | * | |||||||||||||
| OR Confidence Interval | (0.70, 1.05) | (0.46, 0.82) | (0.53, 0.98) | (0.60, 1.07) | (0.420, 0.997) | (0.51, 1.29) | (0.61, 1.08) | (0.37, 0.79) | (0.447, 0.996) | ||||||||||||||||||
| Hospital inpatient daysd | |||||||||||||||||||||||||||
| Average Treatment Effect | −0.09 | −0.23 | *** | −0.14 | * | −0.11 | ** | −0.20 | *** | −0.10 | −0.34 | * | −0.41 | * | −0.08 | ||||||||||||
| ATE Confidence Interval | (−0.19, 0.01) | (−0.34, −0.12) | (−0.26, −0.01) | (−0.18, −0.03) | (−0.30, −0.11) | (−0.19, 0.00) | (−0.61, −0.06) | (−0.74, −0.08) | (−0.40, 0.25) | ||||||||||||||||||
CVD: cardiovascular disease; OR: odds ratio; ATE: average treatment effect
p < 0.05;
p < 0.01;
p < 0.001; 95% confidence intervals
Sample sizes for analyses varied by outcome assessed based on site exclusions due either to the provision of services (i.e., the site did not provide emergency services) or data quality.
The regressions were estimated using a logistic regression. The estimated average treatment effect may be interpreted as a change in the probability of being positive for the outcome.
Analyses for the onset of CVD and ESRD in 2013 were limited to persons without diagnostic codes for those conditions in either FY2011 or FY2012.
The regressions were estimated using a negative binomial model. The estimated average treatment effect may be interpreted as an absolute change in the expected count.