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OBJECTIVES: To estimate trends in the prevalence and comorbidities of diabetes mellitus (DM) in U.S. nursing homes from 1995 to 2004. DESIGN: SAS callable SUDAAN was used to adjust for the complex sample design and assess changes in prevalence of DM and comorbidities during the study period in the National Nursing Home Surveys. Trends were assessed using weighted least squares linear regression. Multiple logistic regressions were used to calculate predictive margins. SETTING: A continuing series of two-stage, cross-sectional probability national sampling surveys. PARTICIPANTS: Residents aged 55 and older: 1995 (n=7,722), 1997 (n=7,717), 1999 (n=7,809), and 2004 (n=12,786). MEASUREMENTS: DM and its comorbidities identified using a standard set of diagnosis codes. RESULTS: The estimated crude prevalence of DM increased from 16.9% in 1995 to 26.4% in 2004 in male nursing home residents and from 16.1% to 22.2% in female residents (all P<.05). Male and female residents aged 85 and older and those with high functional impairment showed a significant increasing trend in DM (all P<.05). In people with DM, multivariate-adjusted prevalence of cardiovascular disease increased from 59.6% to 75.4% for men and from 68.1% to 78.7% for women (all P<.05). Prevalence of most other comorbidities did not increase significantly. CONCLUSION: The burden of DM in residents of U.S. nursing homes has increased since 1995. This could be due to increasing DM prevalence in the general population or to changes in the population that nursing homes serve. Nursing home care practices may need to change to meet residents' changing needs. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to determine if Spanish language preference was significantly associated with barriers to healthcare services among a nationally representative sample of Hispanic persons in the United States. Design: Cross-sectional analysis of secondary data. Differences in outcomes between those responding in Spanish and those responding in English were tested using chi-square analyses and multiple logistic regression models. Setting: Nationally representative sample of US adults responding to the 2005 Behavioral Risk Factor Surveillance System survey. Participants: Respondents identifying them- selves as Hispanic (n=20,400). Main Outcome Measures: Four health care outcomes including health insurance coverage, having a personal health care provider, forgoing care because of cost, and having a routine check-up within the past five years. Results: Those responding in Spanish were less likely to have healthcare coverage, less likely to have a personal healthcare provider, and less likely to have had a routine check-up within the past five years. No difference was found for indicating that cost was a barrier to receiving care in this model. Conclusions: Disparities in healthcare access exist between Hispanic persons in the United States whose language preference is Spanish and those whose language preference is English. In an effort to achieve Healthy People 2010 goals and to provide care to all persons in the United States, barriers to care, such as language preference, should be addressed more fully in our healthcare system. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to determine whether a relationship exists between religious attendance and continuity of care. METHODS: We investigated this relationship in a large national database--the National Health and Nutrition Examination Survey III--which contains information on religious attendance, continuity of care, and potential confounders that might mediate the relationship such as health status and socioeconomic status. RESULTS: A total of 18,162 participants 17 years of age or older were included in the analysis. People who attended religious services were more likely to have continuity with a provider than people who did not attend such services (65% vs. 35%, p < .001). This association persisted after controlling for demographic, socioeconomic, and health status variables using regression analysis. CONCLUSION: This study documents a significant association between attendance at religious services and continuity with a usual provider. Continuity with a regular medical provider may influence the association of religious attendance and health outcomes. [ABSTRACT FROM AUTHOR]