The objective of this study was to explore the relationship between health-related quality of life (HRQOL) and treatment compliance among a sample of patients with diabetes. A sample of 198 employees with diabetes of a large southeastern health plan, who were continuously enrolled in 2004, was surveyed using the Short Form Health Survey (SF-12)--a measure of HRQOL. Of the 198 identified members, 111 (56%) completed and returned the SF-12. Treatment compliance was measured using medical claims data. Compliance scores were then calculated as the number of American Diabetes Association (2005) recommended guidelines completed in 2004. These guidelines include two hemoglobin tests, a cholesterol test, a microalbuminuria test, and an eye exam. Compliance scores ranged from zero (no treatments) to five (all treatments). Both age and the Mental Composite Score (MCS) of the SF-12 were significant predictors of compliance. Age was positively related to compliance, which means that compliance with treatment guidelines increases as a person ages. MCS was negatively related to compliance, which means that those who score lower on the MCS are more likely to be compliant with diabetes care. Results of this pilot study indicate that disease management programs may need to focus special attention on those people with diabetes who are younger and have better mental health. Moreover, factors other than past utilization of care or predicted costs may be beneficial to consider in the inclusion criteria for disease management programs.

The cost burden of depression, anxiety, and emotional disorders is among the greatest of any disease conditions in the workforce. It is worth considering methods for quantifying direct and indirect costs that use administrative data sources given their utility.

Beliefs about risks associated with two risk agents, AIDS and toxic waste, are modeled using knowledge-based methods and elicited from subjects via interactive computer technology. A concept net is developed to organize subject responses concerning the consequences of the risk agents. It is found that death and adverse personal emotional and sociological consequences are most associated with AIDS. Toxic waste is most associated with environmental problems. These consequence profiles are quite dissimilar, although past work in risk perception would have judged the risk agents as being quite similar. Subjects frequently used causal semantics to represent their beliefs and "% of time" instead of "probability" to represent likelihoods. The news media is the most prevalent source of risk information although experiences of acquaintances appear more credible. The results suggest that "broadly based risk" communication may be ineffective because people differ in their conceptual representation of risk beliefs. In general, the knowledge-based approach to risk perception representation has great potential to increase our understanding of important risk topics.

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