The Association between Medicare Annual Wellness Visits and diabetes outcomes among older adults

• Published in: World medical and health policy 2024-03, Vol.16 (1), p.6-18
• Main Authors: Alsulami, Abdulrahman, Dassel, Kara B., He, Yao, Allen, Nancy A.
• Format: Article
• Language: English
• Subjects: 2型糖尿病; Adultos Mayores; Annual Wellness Visits; Atención Primaria; Criteria; Diabetes; Diabetes Mellitus Tipo 2; Medicare; older adults; Older people; Patients; Prevención Primaria; primary care; primary prevention; type 2 diabetes mellitus; Visitas Anuales de Bienestar; 一级预防; 初级保健; 医疗保险; 年度健康检查; 老年人
• ISSN: 1948-4682; 2153-2028; 1948-4682
• DOI: 10.1002/wmh3.579

The rising prevalence of diabetes among older adults is an increasing concern in the United States and is expected to nearly triple within the next 40 years. The purpose of this study was to investigate whether the utilization of Medicare Annual Wellness Visits (AWVs) is associated with changes in type 2 diabetes (T2D) outcomes among older adults Medicare beneficiaries. We conducted an observational retrospective cohort study to compare the T2D outcomes between those who attended AWVs and those who did not from 2017 to 2019. The criteria used for this study include having at least two readings (hemoglobin A1c [A1c] levels, glucose levels, and the number of T2D medications), and for the AWV cohort, the AWVs had to occur between those readings. A total of 508 (2%) Medicare beneficiaries fit our selection criteria. Only 154 (30%) of these patients with T2D participated in AWVs. At baseline, the AWV cohort had lower A1c levels and fewer comorbidities than the non‐AWV cohort. No other statistically significant findings were found. These findings indicate that providers did not utilize AWVs on the more complicated patients, who may need it the most. 摘要 在美国，老年人糖尿病患病率上升一事受到越来越多的关注，并且该患病率预计在未来40年内增加近两倍。本研究旨在调查医疗保险年度健康检查(AWV)的使用是否与老年人2型糖尿病(T2D)结果的变化相关。我们进行了一项观察式回顾性队列研究，以比较2017‐2019年间参加AWV的老年人和没有参加AWV的老年人之间的T2D结果。本研究使用的衡量标准包括至少两个读数（糖化血红蛋白水平、血糖水平和T2D药物数量），对于AWV队列，AWV必须出现在这些读数之间。共有508(2%)名医疗保险受益人符合我们的筛选标准。这些患有T2D的患者中只有154名(30%)参加了AWV。与非AWV队列相比，AWV队列具有较低的糖化血红蛋白水平和较少的合并症。没有发现其他具有统计学显著性的结果。研究发现表明，医疗提供者没有对症状更复杂的患者使用AWV，而他们可能是最需要AWV的患者。 Resumen La prevalencia de la diabetes entre los adultos mayores es una preocupación creciente en los EE. UU. y se espera que casi se triplique en los próximos 40 años. El propósito de este estudio es investigar si la utilización de las visitas anuales de bienestar (AWV) de Medicare está asociada con cambios en los resultados de la diabetes tipo 2 (T2D) entre los adultos mayores beneficiarios de Medicare. Realizamos un estudio observacional de cohorte retrospectivo para comparar los resultados de DT2 entre quienes asistieron a AWV y quienes no asistieron entre 2017 y 2019. Los criterios utilizados para este estudio incluyen tener al menos dos lecturas (niveles de A1c, niveles de glucosa y la cantidad de medicamentos para la DT2), y para la cohorte de AWV, las AWV tenían que ocurrir entre esas lecturas. Un total de 508 (2%) beneficiarios de Medicare cumplen con nuestros criterios de selección. Solo 154 (30%) de estos pacientes con DT2 particip