Insurance, racial/ethnic, SES-related disparities in quality of care among US adults with diabetes

Ruwei Hu, Leiyu Shi, Sarika Rane, Jinsheng Zhu, Chien Chou Chen

Research output: Contribution to journalArticle

Abstract

Diabetes-related quality improvement initiatives are typically aimed at improving outcomes and reducing complications. Studies have found that disparities in quality persist for certain racial/ethnic and socioeconomically disadvantaged groups; however, results are mixed with regard to insurance-based differences. The purpose of this study is to investigate the independent associations between type of health insurance coverage, race/ethnicity, and socioeconomic status (SES), and quality of care, as measured by benchmark indicators of diabetes-related primary care. This study used the Diabetes Care Survey of the 2010 Medical Expenditure Panel Survey. Bivariate and multivariate logistic regressions were used to examine the association between quality of diabetes care and type of insurance coverage, race/ethnicity, and SES. Multivariate analyses also controlled for additional demographic and health status characteristics. Respondents with insurance coverage (particularly those with private insurance or with Medicare and Medicaid coverage) were more likely to receive quality diabetes care than uninsured individuals. Few significant disparities based on race/ethnicity or SES persisted in subsequent multivariate analyses. Findings suggest that insurance coverage may make the greatest impact in ensuring equitable distribution of quality diabetes care, regardless of race/ethnicity or socioeconomic status. With the implementation of Affordable Care Act under which more people could potentially gain access to insurance, policymakers should next track insurance-based diabetes care disparities.

Original languageEnglish (US)
Pages (from-to)565-575
Number of pages11
JournalJournal of Immigrant and Minority Health
Volume16
Issue number4
DOIs
StatePublished - Aug 2014

    Fingerprint

Keywords

  • Diabetes
  • Primary care
  • Quality of care
  • Racial disparities

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this