American Diabetes Association's 73rd Scientific Sessions- Chicago
An Integrated Approach To Improving Diabetes Care and Outcomes on Chicago’s South Side
Peek, M.E., Gao, Y., Goddu, A., Roberson, T., Maltby, D., & Chin, M.H.
Racial minorities suffer disproportionately from diabetes. Few interventions have integrated health care and community approaches to improve outcomes among these populations. Our research team is implementing a 6-clinic intervention to improve diabetes care and outcomes on Chicago’s South Side, a primarily working class African-American community, that includes patient empowerment classes, a quality improvement collaborative, provider training and community partnerships. We annually review 600 randomly identified medical charts (100 charts/clinic) to assess diabetes performance measures. We conducted logistic and linear regression analyses to measure changes in outcomes from 2008 (baseline) to 2010, controlling for site, age, gender, race, treatment type and insurance. 73.9% of patients were African-American, the mean age was 54.5 years, and 29.8% had Medicaid. There were statistically significant improvements in referrals for eye exams, influenza vaccinations, diabetes education, and testing for HbA1c and microalbuminuria. There was a modest improvement in LDL cholesterol (-1.2 mg/dL) and no improvement in HbA1c or blood pressure. Our integrated approach can improve diabetes care among vulnerable populations in real-world settings, but health outcomes may take more than 2 years to show improvements. Our intervention is 7 years and updated analyses are underway.