Care is poor for diabetic patients without insurance and no regular care provider
Research Activities, December 2009, No. 352
Having both health insurance coverage and a usual source of care (USC) are critical to receiving proper care for diabetes, concludes a new study. It found that uninsured patients without a USC are not as likely to get diabetes care services as their counterparts with health insurance coverage. The researchers analyzed data on 6,562 individuals with diabetes who were 18 years of age and older. The information included whether or not they received recommended diabetes-specific preventive services within the past year. These included screening for hemoglobin A1c (a marker of glucose control), blood pressure check, foot and eye examinations, and routine medical care. Various unmet needs (medical, dental, specialty care, delayed care) were also examined by the researchers.
More than 84 percent of the individuals had both full-year health insurance coverage and a USC. The 2.3 percent who had neither benefit received the fewest services in all seven diabetes care categories. They were only one-fifth as likely to have received A1c screening and one-tenth as likely to have blood pressure checks compared with insured individuals with a USC. They were also one-fourth as likely to have received a foot care checkup. The insured group with a USC also had significantly better access to most of the care services. Such individuals had fewer reports of unmet health care needs in the last year. Those who were uninsured with no USC had 5.5 times the odds of having an unmet medical need and more than 3 times the odds of having delayed urgent care or unmet prescription needs. The study was supported in part by the Agency for Healthcare Research and Quality (HS16181).
See "Usual source of care as a health insurance substitute for U.S. adults with diabetes?" by Jennifer E. DeVoe, M.D., D.Phil., Carrie J. Tillotson, M.P.H., and Lorraine S. Wallace, Ph.D., in the June 2009 Diabetes Care 32(6), pp. 983-989.