Receipt of diabetes preventive services differs by insurance status at visit

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Lack of insurance is associated with suboptimal receipt of diabetes preventive care. One known reason for this is an access barrier to obtaining healthcare visits; however, little is known about whether insurance status is associated with differential rates of receipt of diabetes care during visits. Purpose: To examine the association between health insurance and receipt of diabetes preventive care during an office visit. Methods: This retrospective cohort study used electronic health record and Medicaid data from 38 Oregon community health centers. Logistic regression was used to test the association between insurance and receipt of four diabetes services during an office visit among patients who were continuously uninsured (n=1,117); continuously insured (n=1,466); and discontinuously insured (n=336) in 2006-2007. Generalized estimating equations were used to account for within-patient correlation. Data were analyzed in 2013. Results: Overall, continuously uninsured patients had lower odds of receiving services at visits when due, compared to those who were continuously insured (AOR=0.73, 95% CI=0.66, 0.80). Among the discontinuously insured, being uninsured at a visit was associated with lower odds of receipt of services due at that visit (AOR=0.77, 95% CI=0.64, 0.92) than being insured at a visit. Conclusions: Lack of insurance is associated with a lower probability of receiving recommended services that are due during a clinic visit. Thus, the association between being uninsured and receiving fewer preventive services may not be completely mediated by access to clinic visits.

Original languageEnglish (US)
Pages (from-to)229-233
Number of pages5
JournalAmerican Journal of Preventive Medicine
Volume48
Issue number2
DOIs
StatePublished - Feb 1 2015

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Insurance Coverage
Insurance
Office Visits
Preventive Medicine
Ambulatory Care
Community Health Centers
Electronic Health Records
Medicaid
Health Insurance
Cohort Studies
Retrospective Studies
Logistic Models
Delivery of Health Care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Receipt of diabetes preventive services differs by insurance status at visit. / Bailey, Steffani; O'Malley, Jean P.; Gold, Rachel; Heintzman, John; Marino, Miguel; Devoe, Jennifer.

In: American Journal of Preventive Medicine, Vol. 48, No. 2, 01.02.2015, p. 229-233.

Research output: Contribution to journalArticle

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abstract = "Background: Lack of insurance is associated with suboptimal receipt of diabetes preventive care. One known reason for this is an access barrier to obtaining healthcare visits; however, little is known about whether insurance status is associated with differential rates of receipt of diabetes care during visits. Purpose: To examine the association between health insurance and receipt of diabetes preventive care during an office visit. Methods: This retrospective cohort study used electronic health record and Medicaid data from 38 Oregon community health centers. Logistic regression was used to test the association between insurance and receipt of four diabetes services during an office visit among patients who were continuously uninsured (n=1,117); continuously insured (n=1,466); and discontinuously insured (n=336) in 2006-2007. Generalized estimating equations were used to account for within-patient correlation. Data were analyzed in 2013. Results: Overall, continuously uninsured patients had lower odds of receiving services at visits when due, compared to those who were continuously insured (AOR=0.73, 95{\%} CI=0.66, 0.80). Among the discontinuously insured, being uninsured at a visit was associated with lower odds of receipt of services due at that visit (AOR=0.77, 95{\%} CI=0.64, 0.92) than being insured at a visit. Conclusions: Lack of insurance is associated with a lower probability of receiving recommended services that are due during a clinic visit. Thus, the association between being uninsured and receiving fewer preventive services may not be completely mediated by access to clinic visits.",
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