Quality of diabetes care for adults with physical disabilities in Kansas

Amanda Reichard, Ph.D., Hayley Stolzle, M.P.H., Ana Carolina Sella, Ph.D., Theresa I. Shireman, Ph.D.

Disability and Health Journal
Volume 5, Issue 1, Pages 34–40, January 2012

DOI: http://dx.doi.org/10.1016/j.dhjo.2011.09.003




Similar to health disparities found among racial and ethnic minority groups, individuals with physical disabilities experience a greater risk for diabetes than those without disabilities.


The purpose of this works was to assess Kansas Medicaid data to determine the quality of diabetic care and the level to which individuals with physical disabilities’ prevention and diabetes management needs are being met.


We selected a continuously eligible cohort of adults (ages 18 and older) with physical disabilities who had diabetes and received medical benefits through Kansas Medicaid. We examined their quality of care measures (screening for HbA1c/glucose, cholesterol, and eye exams; and, primary care visits) in the succeeding year. Using unconditional logistic regression, we assessed the measures for quality of care as they related to demographic variables and comorbid hypertension.


Thirty-nine percent of the 9,532 adults with physical disabilities had diabetes. They had the following testing rates: HbA1c, 82.7%; cholesterol, 51.5%; and eye examinations, 86.8%. Females, those with dual eligibility, and those with comorbid hypertension had higher rates for all types of screenings and primary care visits. Those living in MUAs had a higher screening rate for cholesterol.


Adults with physical disabilities supported by Kansas Medicaid received diabetes quality indicator screenings have better diabetes quality of care rates for 3 out of 4 measures than nationally published figures for Medicaid. These findings point to a strong quality of care programs in Kansas for this population; however an imperative next step is to determine how effectively this population is managing their blood sugar levels day-to-day.