Pediatric endocrine society survey of diabetes practices in the United States: What is the current state?

Ines Guttmann-Bauman, P. Thornton, S. Adhikari, K. Reifschneider, Ma Wood, T. Hamby, K. Rubin

    Research output: Contribution to journalArticle

    2 Scopus citations

    Abstract

    Background: The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March, 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. Methods: The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. Results: Ninety-three unique entries from the US were entered into analysis. Care is predominantly delivered by multidisciplinary teams, based at academic institutions (65.6%), with >85% of the provider types being physicians. Each 1.0 full time equivalent certified diabetes educators serves on average 367 diabetic youth. Fee-for-service remains the standard method of reimbursement with 57% of practices reporting financial loss. Survey respondents identified under-reimbursement as a major barrier to improving patient outcomes and lack of behavioral health (BH) providers as a key gap in services provided. Conclusions: Our survey reveals wide variation in all aspects of pediatric diabetes care delivery in the United States. Pediatric Endocrinologists responding to the survey identified a lack of resources and the current fee for service payment model as a major impediment to practice and the lack of integrated BH staff as a key gap in service. The respondents strongly support its organizations' involvement in the dissemination of standards for care delivery and advocacy for a national payment model aligned with chronic diabetes care in the context of our emerging value-based healthcare system.

    Original languageEnglish (US)
    JournalPediatric Diabetes
    DOIs
    Publication statusAccepted/In press - Jan 1 2018

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    Keywords

    • Care delivery
    • Diabetes practice
    • Population health

    ASJC Scopus subject areas

    • Internal Medicine
    • Pediatrics, Perinatology, and Child Health
    • Endocrinology, Diabetes and Metabolism

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