Diabetic and Nondiabetic NH Residents Not Receiving Recommended Care

A recent study found that nursing home (NH) residents with diabetes were hospitalized and received rehabilitation or clinically complex care more often than those without diabetes, but neither group received the recommended frequency of preventative procedures (JAMDA. 2016;17[9]:807-813).

Between 2009 and 2011, the Services and Health for Elderly in Long TERm care (SHELTER) project conducted a 12-month, prospective, cohort study to assess 4037 NH residents aged 60 and older residing in 59 NHs in seven European countries and Israel. The international residential assessment instrument tool for long-term care facilities was used to assess care needs. The researchers identified differences between NH residents with diabetes and without diabetes as well as factors determining use of services and care provided to both groups.

Residents with diabetes were hospitalized more often than those without diabetes (18.2% vs 14.3%) and required more rehabilitation (23.8% vs 18.2%) or clinically complex care (15.9% vs 13.7%). They also more frequently received a repositioning program (26.8% vs 22.7%), wound care (15.1% vs 9.8%), and some preventive services such as yearly eye examination (41.0% vs 35.9%), pneumococcal vaccination (33.5% vs 26.6%), mammography in women (12.1% vs 7.4%), and colonoscopy (5.6% vs 3.6%). 

Yet, rates of certain services (mammography, colonoscopy, and hearing and dental examinations) were very low in both study cohorts, with the exception of annual influenza vaccination (82.1%) and yearly blood pressure checkup (95.0%). Interestingly, diabetes enhanced the odds of receiving mammography (OR, 1.55; 95% CI, 1.15-2.09; P = .004) and eye examination (OR, 1.21; 95% CI, 1.03-1.42; P = .018).

Researchers Katarzyna Szczerbińska, MD, PhD (Jagiellonian University Medical College, Kraków, Poland), et al concluded that residents with diabetes receive clinically complex diabetes care more frequently. But, overall, the recommended frequency of preventative procedures is not met in both diabetic and nondiabetic residents. —Amanda Del Signore