Impact of Insurance Status on Health Care Utilization and Quality of Self-Care Among Ethnic Minorities with Type 2 Diabetes

摘要

Type 2 diabetes affects 16 million Americans and disproportionately affects ethnic minorities. Specifically, African American and Hispanics are twice as likely to have Type 2 diabetes compared to their Caucasian counterparts. The impact of this disparity goes beyond the greater prevalence of the disease and includes greater morbidity and mortality. The recent Institute of Medicine (IOM) report documents racial and ethnic disparities in the treatment for many different medical conditions, including diabetes. Understanding and combating health disparities among minority groups is a national priority. Many researchers have focused on socioeconomic status (SES) as the main cause in health disparities. Much of the research over the past two decades has examined the impact of health outcomes among the uninsured and much of this research has found that insured individuals have better health outcomes than those without insurance. In order to begin to unravel the myriad of factors that contribute to these health disparities, researchers must further examine whether there are differences among ethnic minorities and Caucasians with health insurance coverage. The current study examined the association of insurance status on health care utilization patterns and quality of self-care behaviors among ethnic minorities and Caucasians with Type 2 diabetes. The 1998 Medical Expenditure Panel Survey (MEPS), a nationally representative sample of U.S. non-institutionalized civilians, dataset was used in this study. Data were extracted for insured Caucasian, African American, and Hispanic individuals aged 21-64 years with an ICD-9 diagnosis of Type 2 diabetes (i.e., with and without complications). Five hundred six individuals met the inclusion criteria.