Role of Insurance Coverage on Diabetes Preventive Care

Minorities with diabetes are at an increased risk for low quality care and access to resource utilization, specifically health insurance coverage which often determines access to health care. The purpose of the study was to examine the relationship between insurance coverage and diabetes preventive care after adjusting for patient, physician care, and contextual characteristics. Study used data from the 2010 Medical Expenditure Panel Survey (MEPS). Patients represented a weighted total of 20,741,963 (n=2,182). The dependent variables included five measures of the recommended components of diabetes preventive care: receipt of A1C test, retinal eye exam, foot care, blood cholesterol check, and flu vaccination. The independent variables consisted of sociodemographic, physician care, and contextual characteristics. Receipt of each of the diabetes quality and preventive care measures was strongly associated with insurance coverage. Insured individuals were more likely to receive treatment than uninsured. However, the impact of insurance coverage was attenuated after adjusting for individual, physician care, and contextual characteristics. Physician care was the strongest predictor of diabetes preventive care. Our study identified the importance of health insurance coverage on diabetes preventive care. Physician care and contextual factors made a significant impact in receipt of diabetes preventive care.