Early identification and treatment of complications of diabetes mellitus may reduce the severity of the complications. As part of a program to reduce these complications in the Denver Department of Health and Hospitals patient population, our study determined how frequently preventive care, e.g., fundoscopic examinations, referral to an ophthalmologist, foot examinations, and assessment of cardiovascular risk factors, was provided to diabetic patients. With the use of billing records to identify a large sample of diabetic patients, a chart review of 544 patients was conducted. During the study year, the mean ± SE number of visits to primary-care clinics was 5.7 ± 0.22, with 86.4% having at least one visit. Most diabetic patients were seen by primary-care physicians; only 9% received care in a specialized diabetes clinic. Despite frequent primarycare visits, most diabetic patients in this county healthcare system did not have documentation of care to detect complications of diabetes mellitus, and referral services for detection and treatment of these complications were infrequently used. Moreover, among patients seen on >10 occasions in a primary-care setting, preventive care was not provided to 30% of the patients. Preventive care does not appear to be a regular part of a primary-care visit for most of the diabetic patients in this study.
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November 01 1989
Preventive Care in Diabetes Mellitus: Current Practice in Urban Health-Care System
Thomas H Payne, MD;
Thomas H Payne, MD
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Barbara A Gabella, BA;
Barbara A Gabella, BA
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Sharon L Michael, RN, MS;
Sharon L Michael, RN, MS
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Walter F Young, MA;
Walter F Young, MA
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Jeffrey Pickard, MD;
Jeffrey Pickard, MD
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Fred D Hofeldt, MD;
Fred D Hofeldt, MD
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Frances Fan, MD;
Frances Fan, MD
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Jerome S Stromberg, PhD;
Jerome S Stromberg, PhD
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Richard F Hamman, MD, DrPH
Richard F Hamman, MD, DrPH
Denver Health and Hospitals Diabetes Study Group; the Denver Department of Health and Hospitals; the Diabetes Control Program of the Colorado Department of Health; and the Departments of Medicine, Preventive Medicine, and Biometrics, University of Colorado School of Medicine
Denver, Colorado
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Address correspondence and reprint requests to Thomas H. Payne, MD, Center for Health Studies, Group Health Cooperative of Puget Sound, 521 Wall Street, Seattle, WA 98121.
Citation
Thomas H Payne, Barbara A Gabella, Sharon L Michael, Walter F Young, Jeffrey Pickard, Fred D Hofeldt, Frances Fan, Jerome S Stromberg, Richard F Hamman; Preventive Care in Diabetes Mellitus: Current Practice in Urban Health-Care System. Diabetes Care 1 November 1989; 12 (10): 745–747. https://doi.org/10.2337/diacare.12.10.745
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