Identifying diabetes management opportunity areas in the USA.

Autor: Topmiller M; Health Landscape, LLC, Cincinnati, Ohio, USA., Shaak K; Department of Family Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, USA., Mallow PJ; Health Services Administration, Xavier University, Cincinnati, Ohio, USA., Kieber-Emmons AM; Department of Family Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, USA.; School of Medicine, University of South Florida, Tampa, Florida, USA.
Jazyk: angličtina
Zdroj: Family medicine and community health [Fam Med Community Health] 2020 Jan 29; Vol. 8 (1), pp. e000293. Date of Electronic Publication: 2020 Jan 29 (Print Publication: 2020).
DOI: 10.1136/fmch-2019-000293
Abstrakt: Using adherence to diabetes management guidelines as a case study, this paper applied a novel geospatial hot-spot and cold-spot methodology to identify priority counties to target interventions. Data for this study were obtained from the Dartmouth Atlas of Healthcare, the United States Census Bureau's American Community Survey and the University of Wisconsin County Health Rankings. A geospatial approach was used to identify four tiers of priority counties for diabetes preventive and management services: diabetes management cold-spots, clusters of counties with low rates of adherence to diabetes preventive and management services (Tier D); Medicare spending hot-spots, clusters of counties with high rates of spending and were diabetes management cold-spots (Tier C); preventable hospitalisation hot-spots, clusters of counties with high rates of spending and are diabetes management cold-spots (Tier B); and counties that were located in a diabetes management cold-spot cluster, preventable hospitalisation hot-spot cluster and Medicare spending hot-spot cluster (Tier A). The four tiers of priority counties were geographically concentrated in Texas and Oklahoma, the Southeast and central Appalachia. Of these tiers, there were 62 Tier A counties. Rates of preventable hospitalisations and Medicare spending were higher in Tier A counties compared with national averages. These same counties had much lower rates of adherence to diabetes preventive and management services. The novel geospatial mapping approach used in this study may allow practitioners and policy makers to target interventions in areas that have the highest need. Further refinement of this approach is necessary before making policy recommendations.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze: MEDLINE
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