Diabetes Care Thwarted by Unstable Health Insurance: Study

FRIDAY Jan. 6, 2012 -- Diabetes patients require continuous health coverage to ensure they receive recommended care, a new study concludes.

For the study, U.S. researchers analyzed data from nearly 3,400 diabetes patients who received medical care between 2005 and 2007 at 50 federally qualified health centers in Oregon. At these centers, free or reduced-cost care is provided to low-income patients whether they have insurance or not.

Of the patients in the study, 52 percent had continuous health insurance coverage (most often provided by Medicaid), 21 percent had interrupted coverage during the three-year period, and 27 percent had no coverage. Patients with private insurance were not included in the study.

The researchers looked at whether the patients received four health services recommended at least once a year for diabetes patients: a lipid test for high cholesterol; a flu vaccine; a blood sugar level test; and a urine test that can detect kidney damage.

Among patients with continuous insurance, 48 percent received at least three lipid-screening tests during the three-year study, 25 percent received three or more flu shots, 72 percent received three or more blood glucose screenings, and 19 percent underwent three or more screenings for kidney damage.

Patients with interrupted or no coverage received far fewer of these preventive health services, the investigators found.

"Our study shows that patients need continuous health insurance coverage in order to ensure adequate preventive care, even when that care is provided at a reduced cost," study author Rachel Gold, an investigator with the Kaiser Permanente Center for Health Research in Portland, Ore., said in a Kaiser Permanente news release.

While services at the clinics are free, some of the diagnostic tests require a small co-payment that is usually covered by Medicaid. Patients who lose Medicaid coverage often delay getting the tests because they can't afford the co-payment, the researchers noted.

The study, funded in part by the U.S. National Institutes of Health, is published online and in the January-February issue of the Journal of the American Board of Family Medicine.

More information

The American Diabetes Association has more about living with diabetes.

Posted: January 2012


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