Determinants of glycemic status monitoring in black and white Medicaid beneficiaries with diabetes mellitus

Routine monitoring of glycemic status during regularly scheduled physician office visits is not performed according to recommended guidelines for most people with diabetes. We conducted this investigation to identify the determinants of glycemic status monitoring during primary care office visits among Black and White adult Medicaid beneficiaries diagnosed with type 2 diabetes in 1996 and 1997 and followed for a 12-month period through year 1997 and year 1998, respectively (N=3,321). Multivariate logistic regression analyses indicated that the likelihood of receiving the American Diabetes Association (ADA) recommended 2 or more HbA1c tests was more than 2 times greater for persons with diabetes who had 10 or more visits than for those with only one visit in the one-year period since initial diagnosis (relative risk (RR) = 2.31,95% confidence interval (CI) = 1.51-3.51). Quality improvement efforts that emphasize the patient-primary provider relationship and better coordination of care will improve adherence to diabetes care standards.