OBJECTIVE We characterized the receipt of diabetes specialty care and management services among older adults with diabetes. RESEARCH DESIGN AND METHODS Using a 20% random sample of fee-for-service Medicare beneficiaries aged ≥65 years, we analyzed cohorts of type 1 diabetes (T1D) or type 2 diabetes (T2D) with history of severe hypoglycemia (HoH), and all other T2D annually from 2015 to 2019. Outcomes were receipt of office-based endocrinology care, diabetes education, outpatient diabetes health services, excluding those provided in primary care, and any of the aforementioned services. RESULTS In the T1D cohort, receipt of endocrinology care and any service increased from 25.9% and 29.2% in 2015 to 32.7% and 37.4% in 2019, respectively. In the T2D with HoH cohort, receipt of endocrinology care and any service was 13.9% and 16.4% in 2015, with minimal increases. Age, race/ethnicity, residential setting, and income were associated with receiving care. CONCLUSIONS These findings suggest that many older adults may not receive specialty diabetes care and underscore health disparities.

中文翻译：

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2015-2019 年美国老年糖尿病患者接受糖尿病专业护理和管理服务的情况：医疗保险按服务收费索赔分析


目标 我们描述了老年糖尿病患者接受糖尿病专业护理和管理服务的情况。研究设计和方法 我们使用 20% 年龄≥65 岁的按服务付费医疗保险受益人随机样本，分析了有严重低血糖病史 (HoH) 的 1 型糖尿病 (T1D) 或 2 型糖尿病 (T2D) 队列，以及从 2015 年到 2019 年，每年对所有其他 T2D 进行评估。结果是获得办公室内分泌护理、糖尿病教育、门诊糖尿病健康服务（不包括初级保健提供的服务）以及任何上述服务。结果 在 T1D 队列中，接受内分泌护理和任何服务的比例分别从 2015 年的 25.9% 和 29.2% 增加到 2019 年的 32.7% 和 37.4%。在患有 HoH 的 T2D 队列中，2015 年接受内分泌护理和任何服务的比例分别为 13.9% 和 16.4%，增幅甚微。年龄、种族/民族、居住环境和收入与接受护理有关。结论 这些研究结果表明，许多老年人可能没有接受专业的糖尿病护理，并凸显了健康差异。