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Diabetes Better Managed In The UK Than The USA

Posted: Thursday, September 07, 2006

When patients have access to free healthcare, they have better clinical outcomes.

Patients in England with diabetes are better managed than their counterparts in the United States of America due to access to universal healthcare available in the United Kingdom.

Researchers from England and the USA compared diabetes management in the two countries.

"Our evidence shows that universal healthcare when treating a common disease like diabetes, works," said Professor Arch Mainous from the Medical University of South Carolina.

"In both countries, diabetes sufferers are effectively managed as outpatients and our research shows that when patients have access to free healthcare, they have better clinical outcomes.

"Importantly, this finding does not reflect income or social class since better control of the disease amongst people with insurance or free access persists in both countries even among poor patients and minorities.

"A system like the NHS in the UK, which provides universal coverage free at the point of use, may be a model for the USA to examine more closely considering that it spends substantially more of its GDP on healthcare yet has approximately 44 million people without insurance," Professor Mainous said.

Diabetes is a common and potentially disabling chronic disease. Patients are at an increased risk of a number of complications including blindness, renal disease and heart disease.

More than two million people in the UK are known to have diabetes with a further one million estimated to have the disease but not know it. In the USA, an estimated 14.6 million people have been diagnosed with diabetes and a further 6.2 million unaware that they have the disease.

The researchers examined the nationally-representative Health Survey of England (2003) and the National Health and Nutrition Examination Survey (2001-2002, USA) for adults aged 20 - 64 years. They compared measures between US (insured and uninsured) and English sufferers of diabetes including age of diagnosis, glycosylated haemoglobin, cholesterol and blood pressure.

"Diabetes sufferers without insurance cover in the USA have worse control over their condition," said Professor Mainous.

"Compared to patients in England or insured patients in the USA, fewer uninsured individuals were taking necessary medications which have been shown to decrease complications of diabetes, indicating yet another important aspect of access to care.

"Despite differences in the healthcare systems of both countries, many measures of care were similar for the English sample and the US sample with insurance. The research shows that access to health coverage is a key determinant of quality of care for a chronic condition such as diabetes," he said.

Source: Diabetes In Control: 'Diabetes management in the USA and England: evidence of potential advantage to universal access to care' by AG Mainous, VA Diaz, S Saxena, R Baker, CJ Everett, RJ Koopman and A Majeed is published in the September 2006 issue of the Journal of the Royal Society of Medicine.