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Individual, interpersonal, and community factors associated with health outcomes in patients with type 2 diabetes mellitus treated at federally qualified health centers

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Abstract

Purpose

To examine factors of influence in diabetes management and their association with self-reported health outcomes in patients with type 2 diabetes treated at Federally Qualified Health Centers (FQHCs).

Methods

This cross-sectional study examined data from the 2014 Health Center Patient Survey (HCPS). Predictor variables were categorized across three levels of the National Institute on Minority Health and Health Disparities research framework. Outcome variables retrieved from HCPS included self-reports of blood glucose levels, and diabetes-related emergency department (ED)/hospital visits during past year.

Results

A total of 936 patients with diabetes were included. Most (65%) participants received a diabetes self-management plan. During the previous year, 72% received > = 2 A1C checks, 52% reported high blood glucose levels, and 12% visited an ED/hospital. Multivariable results showed that insulin use and receiving a self-management plan were associated with high blood glucose levels and ED/hospital visits. Community factors of being unable to get medications and receiving a specialist foot exam were respectively associated with high blood glucose levels and ED/hospital visits.

Conclusion

Different factors were associated with health outcomes in patients with diabetes treated at FQHCs. Identifying these factors can help with targeted screening and follow-up and assessing potential interventions to improve health outcomes.

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Acknowledgements

Dr. Ali was supported by the University of Wisconsin Primary Care Research Fellowship, funded by grant T32HP10010 from the Health Resources and Services Administration.

The authors gratefully acknowledge Dr. Mindy Smith for the insightful comments of the manuscript.

Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, 610 N. Whitney Way, Madison, WI, 53705, USA

    Asma M. Ali

  2. Department of Quantitative Health Science, Division of Epidemiology, Mayo Clinic College of Medicine and Sciences, Samuel C. Johnson Research Building 2, 13400 East Shea Boulevard, Scottsdale, AZ, 85259, USA

    Ewan K. Cobran

  3. Department Head and Kroger Professor, Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Robert C. Wilson Pharmacy, 250 W. Green Street, Rm: 270-J, Athens, GA, 30602, USA

    Henry N. Young

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Contributions

Drs. Ali and Young contributed to the conception and design of the study and data acquisition. Dr. Ali conducted the data cleaning, analysis, and interpretation, and wrote the initial draft of the manuscript. Drs. Young and Cobran provided statistical expertise and critically reviewed the manuscript for important intellectual content. All authors approved the final draft of the manuscript.

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Correspondence to Asma M. Ali.

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Deidentified publicly available data was used. So, no informed consent was needed or obtained.

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Ali, A.M., Cobran, E.K. & Young, H.N. Individual, interpersonal, and community factors associated with health outcomes in patients with type 2 diabetes mellitus treated at federally qualified health centers. J Diabetes Metab Disord (2024). https://doi.org/10.1007/s40200-024-01388-5

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