NEW YORK, Oct 28 (Reuters Health) -- Health maintenance organizations (HMOs) often emphasize their role in cutting costs by concentrating on preventing disease. But when it comes to screening diabetics for diabetic complications, HMOs have not improved over screening rates in traditional fee-for-service medicine, according to a report released by the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.
The findings are published in the October 29th issue of the CDC's journal Morbidity and Mortality Weekly Report.
Screening tests are useful in preventing "debilitating complications of diabetes, including vision loss, kidney disease, amputation, and disability," according to CDC researchers.
Doctors use three tests -- eye exams, foot exams, and a blood test called glycosylated hemoglobin (GHb) -- to spot early signs of complications from uncontrolled or poorly controlled diabetes.
However, previous surveys have suggested that many diabetic patients receive these tests either infrequently or not at all.
In their study, CDC researchers led by Dr. J.P. Fulton examined 1995-1996 testing rates for over 350 diabetic members of Rhode Island HMOs or PPOs (preferred provider organizations).
According to the researchers, 87% of patients received annual dilated eye examinations aimed at spotting diabetes-related retinopathy -- changes in the blood vessels of the eye that can lead to blindness. This rate of testing is "higher than (that) reported previously and may reflect efforts to enhance retinopathy screening," according to the CDC.
However, patients were less fortunate when it came to receiving either foot exams or GHb testing. "Forty-two percent of persons with diabetes did not receive semi-annual foot examinations and 46% did not receive GHb assessments," according to the CDC. They believe that efforts to improve testing rates should focus on educating patients, healthcare workers, and HMOs as to the value of each of these procedures.
The CDC and the Rhode Island Diabetes Control Program are currently working with various healthcare organizations to ensure that state HMOs adhere to "standards of diabetes care." According to the CDC, "these efforts should improve diabetes care and help to reduce the burden of diabetes complications" for thousands of patients.
