The relationship between insurance and health outcomes of diabetes mellitus patients in Maryland: a retrospective archival record study

Abstract Background Past studies examining the health outcomes of diabetes mellitus (DM) patients found that social determinants disparities were associated with variabilities in outcomes. However, improving access to healthcare, such as insurance, should mitigate negative The aim study was explore association between four types namely, Medicare Fee-For-Service (FFS), Managed Care (MC), Private FFS, and MC plans, DM patients, controlling for patients’ health. Methods This is a retrospective cross-sectional archival record relationships insurance who at least 65 years old, or elderly. Data drawn from 2012 Maryland Clinical Public Use received an exempt status our Institutional Review Board. Elderly residents chronic included study, resulting sample size 43,519 individuals. Predictor variables outcome length hospital stay (LOS), 30-day readmission, end-stage renal disease (ESRD). Control characteristics, patient Student’s t-tests determined statistical differences control insurance. Multiple hierarchical regression analysis applied test plans LOS, while logistic analyses readmission ESRD. Statistical significance set p < 0.05. Results t-test results indicated minimal statuses enrolled different plans. After factoring out variables, FFS had worst ESRD rates. Although on lower rates compared those lowest odds Conclusions data suggests related elderly after considering their Specifically, managed care private better