Abstract
Objectives To assess realized access and equity of access to three components of diabetes care – daily self-monitoring of blood glucose (SMBG), annual dilated eye examination and biannual glycosylated haemoglobin (HbA1c) testing – and to find the factors affecting adherence to these. Methods In this retrospective database analysis, data was obtained from the Behavioral Risk Factor Surveillance System survey. Andersen's behavioural model of health was used to determine the factors that might affect the utilization of the three components of diabetes care. Hierarchical logistic regression was used to determine equity of access to recommended diabetes care. Data analysis was performed using SAS version 9.2. Key findings Realized access was highest for biannual HbA1c testing, followed by annual dilated eye examination and daily SMBG. Enabling resources drove access to daily SMBG and annual HbA1c testing, while access to annual eye exams was driven by predisposing characteristics. Uninsured individuals and those who did not receive diabetes education were less likely to adhere to diabetes care. Conclusions Measures are needed to increase realized access and equity of access to recommended diabetes care.
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