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Variation in quality of care indicators for diabetes in a national sample of veterans and non-veterans. Diabetes Technol Ther 2010 Oct;12(10):785-90



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Scopus ID

2-s2.0-77957944255 (requires institutional sign-in at Scopus site)   11 Citations


BACKGROUND: Veterans have a disproportionately higher burden of type 2 diabetes. It is unclear whether veterans with diabetes have better self-care behaviors or receive better quality of care than non-veterans. The objective was to examine differences in diabetes care between veterans and non-veterans.

METHODS: Data analysis was performed with respondents from the 2003 Behavioral Risk Factor Surveillance Survey (nā€‰=ā€‰21,111 with diabetes). Veterans were those who reported U.S. military service and no longer on active duty. Self-care behaviors included daily fruit and vegetable intake, physical activity level, self-foot checks, and home glucose testing. Quality of care indicators included provider actions over the past 12 months (2+ office visits, 2+ glycosylated hemoglobin checks, 1+ foot exams, 1+ dilated eye exams, daily aspirin use, receiving flu or pneumonia vaccine). Multiple logistic regression using STATA version 10 (Stata Corp., College Station, TX) analyzed differences by veteran status on each quality indicator, controlling for sociodemographics and diabetes education.

RESULTS: Veterans comprised 14.2% of the sample, and 12.4% had diabetes compared to 6.7% of non-veterans. In final adjusted models, veterans were significantly more likely to check their feet (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.09, 1.64), get a dilated eye exam (OR 1.36, 95% CI 1.11, 1.66), receive aspirin (OR 1.31, 95% CI 1.04, 1.65), get a flu shot (OR 1.32, 95% CI 1.09, 1.61), and ever get a pneumonia shot (OR 1.38, 95% CI 1.12, 1.70).

CONCLUSIONS: Veterans appear to have better self-care behaviors and receive better preventive care than non-veterans. However, future efforts need to focus on boosting self-care to improve diabetes outcomes.

Author List

Lynch CP, Strom JL, Egede LE


Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Behavioral Risk Factor Surveillance System
Blood Glucose Self-Monitoring
Diabetes Mellitus
Diabetic Foot
Health Behavior
Middle Aged
Motor Activity
Preventive Health Services
Quality Indicators, Health Care
Quality of Health Care
Self Care
Statistics as Topic
United States
Veterans Health
Young Adult