Diabetes diagnosis and management among insured adults across metropolitan areas in the U.S.
Diabetes diagnosis and management among insured adults across metropolitan areas in the U.S.
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DOI：
10.1016/j.pmedr.2018.03.014
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发表时间：
2018-06
影响因子：
2.8
通讯作者：
Ellen Loh F
中科院分区：
文献类型：
--
作者：
Yang W;Dall TM;Tan E;Byrne E;Iacobucci W;Chakrabarti R;Ellen Loh F
这项研究提供了2012年美国50个最大的大都市地区的糖尿病相关指标-包括诊断和未诊断糖尿病的患病率，糖尿病患者的保险状况，糖尿病药物使用和控制不良的糖尿病患病率。糖尿病患病率估计值的计算采用了结合行为危险因素监测系统、美国社区调查、国家疗养院调查、人口普查人口档案和国家健康与营养检查调查的横断面数据。对医疗索赔文件（2012年去识别规范健康信息数据库，2011年医疗保险标准分析文件和2008年医疗补助分析eXtract）的分析产生了按地理位置，保险类型，性别和年龄组分类的治疗和控制不良的糖尿病信息。在2012年被诊断为2型糖尿病的投保成年人中，接受糖尿病药物治疗的比例从俄克拉荷马州的俄克拉荷马州市的83%到佛罗里达的西棕榈滩的65%不等。在明尼苏达州明尼阿波利斯市（36%），接受治疗的糖尿病控制不佳的患者比例最低，在德克萨斯州的奥斯汀（51%）、圣安东尼奥（51%）和休斯顿（50%）大都市区最高。对大都市地区糖尿病检测和管理的估计往往与州和国家的估计不同。糖尿病管理的当地指标可以帮助跟踪社区随着时间的推移的改善。关键的糖尿病指标因MSA而异，与全国平均水平有很大差异。纽约市有120万成年人患有糖尿病;南部新泽西有50200人。未确诊的糖尿病率从洛杉矶的37%到纳什维尔的24%不等。在投保的2型糖尿病患者中，药物使用率从83%到65%不等。有医疗索赔表明糖尿病不受控制的患者比例为51%至36%。
This study provides diabetes-related metrics for the 50 largest metropolitan areas in the U.S. in 2012—including prevalence of diagnosed and undiagnosed diabetes, insurance status of the population with diabetes, diabetes medication use, and prevalence of poorly controlled diabetes. Diabetes prevalence estimates were calculated using cross-sectional data combining the Behavioral Risk Factor Surveillance System, American Community Survey, National Nursing Home Survey, Census population files, and National Health and Nutrition Examination Survey. Analysis of medical claims files (2012 de-identified Normative Health Information database, 2011 Medicare Standard Analytical Files, and 2008 Medicaid Analytic eXtract) produced information on treatment and poorly controlled diabetes by geographic location, insurance type, sex, and age group. Among insured adults with diagnosed type 2 diabetes in 2012, the proportion receiving diabetes medications ranged from 83% in Oklahoma City, Oklahoma, to 65% in West Palm Beach, Florida. The proportion of treated patients with medical claims indicating poorly controlled diabetes was lowest in Minneapolis, Minnesota (36%) and highest in Texas metropolitan areas of Austin (51%), San Antonio (51%), and Houston (50%). Estimates of diabetes detection and management across metropolitan areas often differ from state and national estimates. Local metrics of diabetes management can be helpful for tracking improvements in communities over time. Key diabetes metrics vary by MSA and differ substantially from the national averages. New York City had 1.2 million adults with diabetes; Southern New Jersey had 50,200. Undiagnosed diabetes rate ranged from 37% in Los Angeles to 24% in Nashville. Among the insured type 2 diabetes patients, medication use ranged from 83% to 65%. Patients with medical claims indicating uncontrolled diabetes ranged from 51% and 36%.