Diabetes processes of care in the Australian veteran population

Objective To determine the proportion of veterans with diabetes who had claims for recommended processes of diabetes care in 2005. Design Observational study of 19,810 veterans' dispensed medicines indicative of diabetes. Claims to the Department of Veterans' Affairs for HbA 1c , microalbuminuria, ophthalmology or optometry services, podiatry services, diabetes care plans, medication reviews, case conferences and GP management plans were assessed. Results Overall 63% had at least one HbA 1c claim in the year under review, while 40% had a microalbuminuria claim. The majority (87%) had a claim for an ophthalmology or optometry service, while two-thirds had a podiatry service claim. Only one-fifth had claims for an annual diabetes care plan. Just under half had a claim for any type of care plan, including medication review, discharge plan, case conference, GP management plan or health care plan. Veterans resident in aged-care facilities were significantly less likely to have claims for any of these services apart from medication review. Conclusions While administrative claims data may under-represent some processes of care carried out routinely in general practice, this study suggests under-utilisation of services for veterans with diabetes, particularly those resident in aged-care facilities.