Brooklyn has Lowest Testing Rates and Largest Number of Patients, According to Data Released by IPRO
LAKE SUCCESS, NY- September 25, 2003 - Data released today by IPRO show that African-American Medicare beneficiaries who have diabetes and reside in New York City are less likely to be given lipid (HDL, LDL, triglycerides, total cholesterol) tests than other beneficiaries with diabetes. The disparity in lipid test administration is greatest in the borough of Brooklyn, which has a disparity rate of 17% as well as the largest number of African-American beneficiaries with diabetes -- 5,649. Some neighborhoods in Brooklyn such as Coney Island and Sheepshead Bay have disparities as high as 22% (see Table 2). Statistics are based on IPRO's analysis of Medicare claims and represent the most recent data available -- from October 2000 to September 2002. IPRO is an independent healthcare quality improvement organization responsible for facilitating improvement in Medicare-financed care in New York State.
"Diabetes is a strong risk factor for heart disease, so it is critical that all diabetes patients be tested every year," says Terry Mahotiere, MD, MPH, Medical Officer at IPRO. "Because of the heavy burden of diabetes in the African-American community it is our hope that physicians who serve the community review these findings and understand that they should make special efforts to protect their patients."
Approximately 2.8 million or 13% of all African-Americans have diabetes in the United States. According to the most recent Behavioral Risk Factor Surveillance System report, African Americans are twice as likely to have diabetes than whites in the state of New York.
1. In addition, the NYC 2002 Community Health Survey reported that twice as many African-American adults have diabetes than white adults in New York City and the overall prevalence of diabetes was greatest in the boroughs of Brooklyn and Bronx.
2. According to the American Diabetes Association (ADA), the most life-threatening consequences of diabetes are heart disease and stroke, which strike people with diabetes more than twice as often as they do others. The ADA estimates that improved control of cholesterol (high density lipoproteins, low density lipoproteins, triglycerides) can reduce cardiovascular complications by 20% to 50%. Adults with diabetes have heart disease death rates two to eight times higher than those without diabetes.
To address the lipid test disparity among African-American beneficiaries, IPRO is conducting a series of intervention programs including one-on-one educational training and support, chart audits and cultural competency training in health centers, clinics and physician offices in New York City communities where a large proportion of the diabetes population is African American. IPRO has also partnered with local nursing schools to provide diabetes self-management and cardiovascular disease prevention education programs in community senior centers.
"It is important that lipid tests are fully used in communities such as Brooklyn where diabetes is a major health problem and testing rates are low," states Anthony Shih, MD, MPH, Vice President of Quality Improvement at IPRO. "People with diabetes should speak with their healthcare professional about which tests are necessary in order to take total control over their diabetes."
Diabetes is becoming more prevalent in all age groups. The increasing prevalence is attributed both to higher detection and to poorer health habits (increased rates of obesity being the primary culprit). According to the National Health Interview Survey (NHIS), the overall prevalence of Type II diabetes is 1.3 percent at 18-44 years, 6.2 percent at 45-64 years, and 10.4 percent for those aged 65 and older.
3. With nearly 20 years experience in health care quality evaluation, IPRO holds major contracts with state and federal governments to review the cost and quality of services provided to Medicaid recipients, Medicare beneficiaries, and patients enrolled in managed care organizations. Based in Lake Success, New York, IPRO also holds contracts with private-sector clients to improve the quality of privately financed services.
References:
1.Behavioral Risk Factor Surveillance System-Summary Report. New York State Department of Health. Vol. 5, No. 2, Winter 1997.
2. Thorpe LE et al. Diabetes is Epidemic. NYC Vital Signs 2003: 2 (1); 1-4.
3.National Center for Health Statistics Report for National Centers for Disease Control and Prevention.1999. National Health Interview Survey
Tables Attached