967-P: Decentralizing Diabetes Specialty Care Improves Glycemic Control

Abstract

Parkland Health and Hospital System (PHHS) is the Dallas County safety-net health system and serves indigent Dallas County residents. PHHS has primary care clinics (COPCs) located in underserved areas of the county to provide easier access to its residents. The Diabetes Specialty Clinic (DSC) is located next to the Parkland Hospital, but this location can be difficult to access for patients with limited means. We studied the effect of co-locating a diabetes specialty practice (H-DSC) at a community primary care practice (Hatcher Station COPC (HSC)) by comparing the A1c change between the patients managed by primary care providers at HSC alone or by specialists at H-DSC. Table 1 displays the results of this study. The data show that there was a significant reduction in A1c in the HSC patients seen by primary care and H-DSC patients of -0.2% and -0.5% respectively. There is also a significant difference in baseline and final A1cs between both groups that show that H-DSC patients had poorer baseline glycemic control but also greater improvement in glycemic control. H-DSC patients were also being seen by their primary care providers at HSC, and without the co-location of the DSC to H-DSC, many of these patients would not have accessed care at the DSC main location. This suggests that co-locating diabetes specialty services at local, easy-to-access primary care centers at a safety-net health system can improve the glycemic control of patients with diabetes. Disclosure U.Gunasekaran: None.