Introduction& Objective: ADA recommends DSMES in general and at critical time points, such as hospital admission - a care transition. The National Health and Nutrition Examination Survey (NHANES) has asked about receipt of care from providers of DSME (nurse educators / dieticians) since 2005. Our aim was to characterize predictors of receipt of DSMES services with a focus on health system factors in NHANES, a nationally representative sample of the U.S. population.
Methods: This cross sectional study utilized NHANES 2005-2018 limited to those self-reporting diabetes and age ≥ 30. Our primary outcome was ever receipt of DSMES. Predictors of interest were insurance, current PCP, and recent hospital admit. Analyses used Student T-test, Chi square, and logistic regression as appropriate. All analyses were done in SAS and used weighting/sampling to account for the complex survey design of NHANES.
Results:4612 met eligibility. Those with A1C ≥ 9.0 were more likely to be younger; male of non-Hispanic black race/ethnicity (NHB); and on insulin. In multivariable analyses high A1C, NHB race/ethnicity, age ≤ 65, presence of PCP, and hospital admit were positively associated with DSME. Receipt of DSME has been decreasing over time.
Conclusion: Health system factors such as presence of PCP and recent hospital admit were positively associated with receipt of DSMES but insurance status was not associated with DSMES.
A.R. Montero: None. J. Nam: None.
