ISQUA16-1522QUALITY AND PREDICTORS OF DIABETES CARE AMONG PATIENTS WITH SCHIZOPHRENIA

Abstract

Objectives: Data on the quality of care for diabetes among patients with schizophrenia remain sparse, in particular from universal and free of charge health care systems. This study aimed to compare the quality of care for diabetes among patients with and without schizophrenia in Denmark and to identify predictors of quality of care. Method(s): In a nationwide population-based cohort study, we identified 83,813 diabetic patients including 669 with schizophrenia between 2005 and 2013 from Danish national registries. Quality of diabetes care was defined as having fulfilled guideline recommended performance measures of care. The examined potential predictors of diabetes care among patients with schizophrenia included patient-, (gender, age, abuse, the Global Assessment of Functioning (GAF) score, disease duration of schizophrenia) provider-, (preceding received quality of schizophrenia care) and system-specific factors (contact volume defined as the individual diabetes clinic's average caseload volume of patients per year during the study period). Result(s): Compared to patients without schizophrenia, patients with schizophrenia had a lower chance of receiving a high overall quality of care (i.e., fulfilling >=80 % of all performance measures of care) (Relative risk (RR) 0.91, 95%CI: 0.88-0.95) as well as individual performance measures including blood pressure measurement (RR 0.98, 95%CI: 0.96-0.99), treatment with antihypertensives (RR 0.83, 95%CI: 0.70-0.97) and ACE (angioten-sin concerting enzyme)/ATII (angiotensin receptor blocker) inhibitors (RR 0.72, 95%CI: 0.55-0.93), albuminuria measurement (RR 0.96, 95%CI: 0.93-0.99), eye examination at least every second year (RR 0.97, 95%CI: 0.94-0.99) and feet examination (RR 0.96, 95% CI: 0.93-0.99). Predictors of care included age, abuse, duration of schizophrenia and contact volume. Conclusion(s): Quality of care for diabetes was substantially lower for patients with schizophrenia compared to patients without schizophrenia. Predictors of care included both patient- and system-specific factors.