Healthcare utilization and diabetes management programs: Indiana 2006-2010.

Mayo-Gamble TL, Lin HC
Am J Manag Care. 2014 20 (10): e461-8

PMID: 25414984

OBJECTIVES - Healthcare utilization and participation in diabetes management programs have shown to be beneficial to overall health in patients with type 2 diabetes mellitus (T2DM). To improve the effectiveness of healthcare activities on diabetes health outcomes, factors associated with healthcare activities such as physician seeking and participating in a diabetes management class need to be identified.

DESIGN AND METHODS - A retrospective multi-year cross-sectional analysis was conducted. Data were collected using data sets from the 2006 to 2010 Behavioral Risk Factor Surveillance System Survey. A Poisson regression was conducted to capture the influence of predisposing, enabling, and need factors on the number of physician visits for diabetes. A logistic regression was conducted to capture the influence of the aforementioned factors on participation in a diabetes management class.

RESULTS - Results of the Poisson regression indicate patients who were taking insulin, more frequently check for sores, or have hemoglobin exams, had made more physician visits (incident rate ratios = 1.34, 1.04, and 1.05, respectively; all P < .01). Results of the logistic regression indicate patients who were taking insulin or more frequently check for sores (odds ratio [OR] = 1.48, 1.37, 1.43, 0.74, 1.30, 1.07, and 1.06, respectively; all P < .01), were more likely to participate in a diabetes management class. Results also indicated patients who were male or married were less likely to participate in a diabetes management class (OR = 0.69, P < .05; OR = 0.81, P < .01 respectively).

CONCLUSIONS - Evidence supports sociological factors as important facilitators promoting healthcare utilization in patients with increased T2DM severity levels. Interventions to improve healthcare utilization should acknowledge sociological factors, particularly self-care factors.

MeSH Terms (19)

Adult Aged Age Factors Behavioral Risk Factor Surveillance System Cross-Sectional Studies Diabetes Mellitus, Type 2 Female Humans Indiana Insulin Male Middle Aged Patient Acceptance of Health Care Patient Education as Topic Poisson Distribution Psychology Retrospective Studies Self Care Young Adult

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