...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Diabetes care >The Affordable Care Act: Effects of Insurance on Diabetes Biomarkers
【24h】

The Affordable Care Act: Effects of Insurance on Diabetes Biomarkers

机译：经济实惠的护理法：保险对糖尿病生物标志物的影响

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE We sought to understand how Affordable Care Act (ACA) Medicaid expansion insurance coverage gains are associated with changes in diabetes-related biomarkers. RESEARCH DESIGN AND METHODS This was a retrospective observational cohort study using electronic health record data from 178 community health centers (CHCs) in the ADVANCE (Accelerating Data Value Across a National Community Health Center Network) network. We assessed changes in diabetes-related biomarkers among adult patients with diabetes in 10 Medicaid expansion states (n= 25,279), comparing newly insured with continuously insured, discontinuously insured, and continuously uninsured patients pre- to post-ACA expansion. Primary outcomes included changes from 24 months pre- to 24 months post-ACA in glycosylated hemoglobin (HbA(1c)), systolic (SBP) and diastolic (DBP) blood pressure, and LDL cholesterol levels. RESULTS Newly insured patients exhibited a reduction in adjusted mean HbA(1c)levels (8.24% [67 mmol/mol] to 8.17% [66 mmol/mol]), which was significantly different from continuously uninsured patients, whose HbA(1c)levels increased (8.12% [65 mmol/mol] to 8.29% [67 mmol/mol]; difference-in-differences [DID] -0.24%;P< 0.001). Newly insured patients showed greater reductions than continuously uninsured patients in adjusted mean SBP (DID -1.8 mmHg;P< 0.001), DBP (DID -1.0 mmHg;P< 0.001), and LDL (DID -3.3 mg/dL;P< 0.001). Among patients with elevated HbA(1c)in the 3 months prior to expansion, newly insured patients were more likely than continuously uninsured patients to have a controlled HbA(1c)measurement by 24 months post-ACA (hazard ratio 1.25; 95% CI 1.02-1.54]. CONCLUSIONS Post-ACA, newly insured patients had greater improvements in diabetes-related biomarkers than continuously uninsured, discontinuously insured, or continuously insured patients. Findings suggest that health insurance gain via ACA facilitates access to appropriate diabetes care, leading to improvements in diabetes-related biomarkers.
机译：目的我们试图了解经济实惠的护理法案（ACA）医疗补助扩张保险覆盖率覆盖率与糖尿病相关生物标志物的变化有关。研究设计和方法这是一种回顾性观察队列，其使用来自178个社区健康中心（CHC）的电子健康记录数据（在国家社区卫生中心网络的数据价值加速数据值）网络中。我们评估了10名医疗补助扩张状态（n = 25,279）的成人糖尿病患者糖尿病相关生物标志物的变化（n = 25,279），并将新被保险，不连续保险和不受保险的患者预先持续的患者进行比较。主要结果包括在糖基化血红蛋白（HBA（1C）），收缩系统（SBP）和舒张（DBP）血压和LDL胆固醇水平的24个月前24个月的变化。结果新被保险患者的调整后平均HBA（1C）水平降低（8.24％[67mmol / mol]至8.17％[66mmol / mol]），其与连续未经保险的患者显着不同，其HBA（1C）水平增加（8.12％[65mmol / mol]至8.29％[67 mmol / mol];差异差异[DID] -0.24％; p <0.001）。新被保险的患者表现出比调整平均SBP的连续未经保险的患者更加减少（DID -1.8 mmHg; P <0.001），DBP（DID -1.0mmHg; P <0.001）和LDL（DID -3.3mg / dL; P <0.001 ）。在膨胀前3个月内HBA（1C）升高的患者中，新被保险的患者比不受保险的患者更可能在ACA后24个月（危险比1.25; 95％CI 1.02（95％CI 1.02）中具有控制的HBA（1C）测量。 -1.54]结论后-ACA，新参保患者在糖尿病相关的生物标志物不是连续无医疗保险，参保间断或连续参保的患者。调查结果表明通过ACA医保增益有利于获得适当的糖尿病护理更大的改善，从而改善在糖尿病相关的生物标志物。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号