PMID- 19415391
OWN - NLM
STAT- MEDLINE
DCOM- 20100929
LR  - 20211020
IS  - 1525-1497 (Electronic)
IS  - 0884-8734 (Print)
IS  - 0884-8734 (Linking)
VI  - 24
IP  - 7
DP  - 2009 Jul
TI  - Retrospective analysis of diabetes care in California Medicaid patients with 
      mental illness.
PG  - 802-8
LID - 10.1007/s11606-009-0994-9 [doi]
AB  - BACKGROUND: Serious mental illness often is associated with an increased risk of 
      diabetes and sub-optimal diabetes care. OBJECTIVE: To examine diabetes prevalence 
      and care among Medicaid patients from one county mental health system. DESIGN: 
      Retrospective cohort study combining county records and 12 months of state 
      Medicaid claims. SUBJECTS: Patients ages 18 to 59 receiving mental health 
      services between November 1 and 14, 2004. MEASUREMENTS: Dependent variables were 
      glycolated hemoglobin A1C (HbA1c) testing, lipid testing, and eye examinations. 
      Psychiatric status was assessed by second generation antipsychotic prescription 
      (SGA) and low Global Assessment of Functioning (GAF) score. RESULTS: Among 
      psychiatric patients, 482 (11.8%) had diabetes. Among those with diabetes, 47.3% 
      received annual HbA1c testing, 56.0% lipid testing, and 31.7% eye examinations. 
      Low GAF scores were associated with lower likelihood of lipid testing (OR 0.43). 
      SGA prescription reduced the likelihood of HbA1c testing (OR 0.58) but increased 
      the likelihood of eye examinations (OR 2.02). Primary care visits were positively 
      associated with HbA1c and lipid testing (ORs 5.01 and 2.21, respectively). 
      Patients seen by a fee-for-service psychiatrist were more likely to have lipid 
      testing (OR 2.35) and eye examinations (OR 2.03). CONCLUSION: Among Medicaid 
      psychiatric patients, worse diabetes care was associated with SGA prescription, 
      more serious psychiatric symptoms, and receiving psychiatric care only in public 
      mental health clinics. Diabetes care improved when patients were seen by 
      fee-for-service psychiatrists or primary care physicians. Further study is needed 
      to identify methods for improving diabetes care of public mental health patients.
FAU - Banta, Jim E
AU  - Banta JE
AD  - Department of Health Policy and Management, School of Public Health, Loma Linda 
      University, 24951 North Circle Drive, Loma Linda, CA 92350, USA. jbanta@llu.edu
FAU - Morrato, Elaine H
AU  - Morrato EH
FAU - Lee, Scott W
AU  - Lee SW
FAU - Haviland, Mark G
AU  - Haviland MG
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090505
PL  - United States
TA  - J Gen Intern Med
JT  - Journal of general internal medicine
JID - 8605834
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - California/epidemiology
MH  - Diabetes Mellitus/*drug therapy/epidemiology/therapy
MH  - Female
MH  - Health Services Research
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - *Medicaid
MH  - *Mental Disorders
MH  - Mental Health
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Statistics as Topic
MH  - United States/epidemiology
MH  - Young Adult
PMC - PMC2695534
EDAT- 2009/05/06 09:00
MHDA- 2010/09/30 06:00
PMCR- 2010/07/01
CRDT- 2009/05/06 09:00
PHST- 2008/07/17 00:00 [received]
PHST- 2009/04/09 00:00 [accepted]
PHST- 2008/12/23 00:00 [revised]
PHST- 2009/05/06 09:00 [entrez]
PHST- 2009/05/06 09:00 [pubmed]
PHST- 2010/09/30 06:00 [medline]
PHST- 2010/07/01 00:00 [pmc-release]
AID - 994 [pii]
AID - 10.1007/s11606-009-0994-9 [doi]
PST - ppublish
SO  - J Gen Intern Med. 2009 Jul;24(7):802-8. doi: 10.1007/s11606-009-0994-9. Epub 2009 
      May 5.