Insurance continuity and receipt of diabetes preventive care in a network of federally qualified health centers.

Abstract:

BACKGROUND AND OBJECTIVES:Having health insurance is usually associated with better access to care and better health outcomes. For patients receiving care at Federally Qualified Health Centers (FQHCs), where care is provided regardless of insurance status, the role health insurance status plays in affecting receipt of services is less well understood. RESEARCH DESIGN:We used practice management data from a coalition of FQHCs in Oregon, and linked to Oregon's electronic insurance data, to examine whether receipt of diabetes preventive care services was associated with continuity of insurance coverage among adult FQHC patients receiving diabetes care in 2005. RESULTS:About one-third (32%) of patients with diabetes received a flu vaccination in 2005, 36% an LDL screening, 54% at least 1 HbA1c screening, and 21% a nephropathy screening. Compared with the continuously insured, the continuously uninsured were less likely to receive an LDL screening, a flu vaccination, and/or a nephropathy screening; those with partial coverage were less likely than the continuously insured to receive a flu shot, at least 1 HbA1c screening, or an LDL screening. CONCLUSIONS:Our results suggest that FQHCs do an excellent job in delivering most services to their uninsured and partially insured patients, but also underscore that for diabetic patients from underserved communities, having both an FQHC medical home and continuous health insurance plays a critical role in receiving optimal chronic disease management. Our study is one of the first to demonstrate how electronic administrative data from a network of FQHCs can be successfully used to gauge the state of healthcare delivery.

journal_name

Med Care

journal_title

Medical care

authors

Gold R,DeVoe J,Shah A,Chauvie S

doi

10.1097/mlr.0b013e318190ccac

subject

Has Abstract

pub_date

2009-04-01 00:00:00

pages

431-9

issue

4

eissn

0025-7079

issn

1537-1948

journal_volume

47

pub_type

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