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首页> 外文学位 >Access to care in type 2 diabetes in youth: Do disparities exist between Medicaid and private insurance?
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Access to care in type 2 diabetes in youth: Do disparities exist between Medicaid and private insurance?

机译：青年2型糖尿病的医疗服务：医疗补助与私人保险之间是否存在差异？

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摘要

While Medicaid coverage improves access to care, access disparities remain between youth with Medicaid and private insurance. The purpose of this study was to evaluate whether having Medicaid versus private insurance impacts access to care for youth with type 2 diabetes, an emerging health concern with long-term patient and health system implications.;A secondary database analysis of youth age 5--19 with type 2 diabetes was undertaken in a national electronic medical record (EMR) database. Patients had at least 90 days of EMR activity after their first indication of type 2 diabetes, and all had Medicaid or private insurance. Descriptive statistics and multivariate regression analyses were used to test the hypotheses that (1) youth with Medicaid have less access to physician care the year prior to their first indication of type 2 diabetes in the EMR; and (2) that Medicaid influences access to diabetes-related care in terms being less likely to receive prescription drugs but more likely to receive tests to monitor blood glucose control.;A total of 2496 youth were included including 400 (16%) with Medicaid coverage. Over 60% were female with a age of 14.5 years, and over two thirds were obese. The study found that youth with Medicaid were not less likely to have access to physician care prior to their first indication of type 2 diabetes in the EMR. However, by study design, all youth in the study had overcome basic access barriers in entering the EMR system. Similarly, youth with Medicaid did not have reduced access to prescription drugs relative to private insurance. They were more likely to have their blood glucose control tested at baseline, as predicted, but not during a one year follow-up period.;This study suggests that if barriers to accessing physician care can be reduced for youth with Medicaid, they may not receive a lower level of diabetes care than youth with private insurance. Thus, health policy measures to ensure that Medicaid physician networks provide adequate and accommodating coverage in low-income areas may help to reduce diabetes-related care access barriers that Medicaid youth with type 2 diabetes may disproportionately face.
机译：虽然医疗补助覆盖范围可改善获得护理的机会，但有医疗补助的年轻人与私人保险之间的获取差距仍然存在。这项研究的目的是评估医疗补助与私人保险是否会影响2型糖尿病青年的健康状况，而这种疾病是对健康的长期关注，对患者和医疗系统都有长期影响。;对5岁以下青年的二级数据库分析在国家电子病历（EMR）数据库中进行了19例2型糖尿病的研究。在首次发现2型糖尿病后，患者至少有90天的EMR活动，并且所有患者均享有医疗补助或私人保险。描述性统计和多元回归分析用于检验以下假设：（1）患有Medicaid的青年在EMR中首次发现2型糖尿病之前一年就没有医生护理； （2）Medicaid会减少接受处方药的可能性，但更可能接受监测血糖控制的检查，从而影响到与糖尿病相关的护理的获取。总共纳入2496名青年，其中400名（16％）接受Medicaid覆盖范围。超过60％的女性年龄为14.5岁，超过三分之二的肥胖。研究发现，医疗补助的年轻人在EMR中首次发现2型糖尿病之前，不太可能获得医生的护理。但是，通过研究设计，研究中的所有年轻人都克服了进入EMR系统的基本访问障碍。同样，与私人保险相比，有医疗补助的年轻人也没有减少获得处方药的机会。如预期的那样，他们更有可能在基线时进行血糖控制测试，但在一年的随访期内却没有。;这项研究表明，如果可以减少Medicaid青年获得医生护理的障碍，他们可能不会与拥有私人保险的青年相比，他们接受的糖尿病护理水平较低。因此，确保低收入地区医疗补助医生网络提供足够且适度的医疗保健政策措施可能有助于减少2型糖尿病医疗补助青少年可能不成比例地面临的与糖尿病相关的护理障碍。

著录项

  • 作者

    Marx, Carrie McAdam.;

  • 作者单位

    University of the Sciences in Philadelphia.;

  • 授予单位 University of the Sciences in Philadelphia.;
  • 学科 Health Sciences Public Health.;Health Sciences Health Care Management.
  • 学位 Ph.D.
  • 年度 2009
  • 页码 161 p.
  • 总页数 161
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;预防医学、卫生学;
  • 关键词

  • 入库时间 2022-08-17 11:38:25

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