Adherence to American Diabetes Association guidelines in a volunteer-run free clinic for the uninsured: better than standards achieved by clinics for insured patients

R I Med J (2013). 2013 Jan 4;96(1):25-9.

Abstract

To determine whether Type 2 diabetes care for the uninsured is comparable to care provided to insured patients, we compared a free clinic's compliance with American Diabetes Association (ADA) clinical practice guidelines to 6 adherence evaluations in the literature. We examined diabetes management-related biomarkers, compliance with ADA-recommended health monitoring events, and presence of other health-promoting behaviors via retrospective chart review (n = 33). Results demonstrate that standards achieved by the free clinic were commensurate with, if not outperforming, published standards achieved in settings for insured patients. This evaluation emphasizes that free clinics can provide high-quality diabetes management care to patients with limited resources. This review also provides a benchmark against which results of future diabetes management interventions in both free and conventional clinic settings can be compared.

Keywords: ADA Recommendation; Free Clinic; Health Disparities; Type 2 Diabetes; Uninsured.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Care Facilities / economics
  • Ambulatory Care Facilities / standards
  • Biomarkers
  • Blood Glucose Self-Monitoring
  • Chronic Disease / prevention & control
  • Chronic Disease / therapy
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glucose Tolerance Test
  • Glycated Hemoglobin / analysis
  • Guideline Adherence / standards*
  • Healthcare Disparities
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Male
  • Mass Screening / methods
  • Medically Uninsured / ethnology
  • Medically Uninsured / statistics & numerical data*
  • Middle Aged
  • Outcome Assessment, Health Care / statistics & numerical data
  • Poverty Areas
  • Practice Guidelines as Topic
  • Primary Health Care
  • Retrospective Studies
  • Rhode Island
  • Uncompensated Care / statistics & numerical data*
  • United States

Substances

  • Biomarkers
  • Glycated Hemoglobin A