1288-P: The Association between CDSS Use and Diabetes Management

Abstract

Research Objective: Healthcare providers’ decision-making can be aided by a computerized decision support system (CDSS) that might include alerts for drug allergies, checks for drug-drug interactions, and reminders for preventive screening tests. Over 30 million Americans suffer from diabetes. Diabetes prevalence and management success rates vary based on the patient’s age, gender, race, socioeconomic status, and location. The effectiveness of CDSS on overall patient outcomes haven’t been fully evaluated. This project aims to test the association between CDSS use and diabetic patients’ blood glucose level. Study Design: We used FQHC annual report for the period 2014-2017. The outcome variable was the percentage of patients 18-75 years of age with diabetes who had hemoglobin (HbA1c) less than 8.0 percent during the measurement period. The independent variable was the use of CDSS. The study controlled for organizational and patient characteristics. To uncover the average effect of a covariance over the entire sample, generalized estimating equations model with state and year fixed effects was utilized. Principal Findings: The use of CDSS at FQHCs was associated with 6.2 percent improvement in diabetic control (p=0.037). Moreover, 1 percent increase in patients with Medicare coverage was significantly associated with better diabetic control (0.36, p<0.001). Likewise, an increase in patients with private insurance was associated with better diabetic control (0.13, p=0.003). Asian and Hispanics, compared to whites, were more likely to maintain their blood glucose at adequate levels (0.26, p<0.001, and 0.07, p=0.008, respectively). Conclusions: Study suggests the use of CDSS may lead to better health outcomes for patients with diabetes at FQHC. The findings of this study can help tailor treatment to vulnerable populations, inform funding agencies with respect to policies to incentivize and encourage FQHCs to adopt and use CDSS. Further, FQHC administrators can gain insight to make informed decisions to invest in CDSS. Disclosure G. Davlyatov: None. N. Baidwan: None. T. Mehta: None.