Receipt of recommended services among patients with selected disabling conditions and diabetes.

BACKGROUND: Receiving recommended services for patients with diabetes is associated with improved outcomes and reduced morbidity. People with diabetes who also have a condition associated with disability represent one group that is at risk for health disparities.

OBJECTIVE: To examine service utilization among persons with selected disabling conditions and diabetes, compared to those without.

METHODS: 2007-2012 Medical Expenditure Panel Survey Full-Year Consolidated files, medical conditions files, and the 1996-2012 pooled linkage files were merged for this analysis. This analysis focused on five selected conditions that are associated with disability: Visual impairment and blindness, spinal cord injury, intellectual disability, multiple sclerosis, and muscular dystrophy. Unadjusted and adjusted rates of receipt estimated using various multivariable regression techniques.

RESULTS: The proportion with diabetes was higher among those with a selected condition (12.1%) than without (7.1%). Respondents with a selected condition were more likely to have a foot exam; for all other services, the rate of receipt across the two groups was similar. Controlling for other factors, having a selected condition was only a significant factor for foot exams (AOR 1.49, 1.07-2.07). Different factors, but not having a selected condition, were associated with the receipt of each additional service.

CONCLUSIONS: In general, individuals received the full complement of recommended diabetes management services at a low rate, whether or not they had one of the selected disabling conditions. The comparison results indicated few disparities in diabetes management services among those with selected conditions compared those without these conditions, excepting foot exams, which were more common in the group with a disabling condition.