Risk of Diabetes Mellitus Among Medicaid Beneficiaries in Hawaii.
Risk of Diabetes Mellitus Among Medicaid Beneficiaries in Hawaii.
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DOI：
10.5888/pcd14.170095
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发表时间：
2017-11-22
影响因子：
5.5
通讯作者：
Ozaki RR
中科院分区：
文献类型：
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作者：
Li D;Chinn CC;Fernandes R;Wang CMB;Smith MD;Ozaki RR
医疗补助是美国低收入人群最大的初级健康保险，它提供全面的福利，以支付包括糖尿病在内的慢性病的治疗和服务费用。从2012年到2015年，参加夏威夷收费服务计划的医疗保险受益人在糖尿病方面的标准化人均支出有所增加。我们研究了夏威夷主要种族/民族中医疗补助和非医疗补助人群之间糖尿病发病率的差异。在这项横断面研究中，我们使用了夏威夷行为风险因素监测系统2013年至2015年的数据，比较了医疗补助（n = 1，889）和非医疗补助（n = 17，207）受益人之间自我报告糖尿病风险的差异。我们使用多变量逻辑回归模型，可以适应复杂的抽样设计，以检查2个人群之间糖尿病的几率差异。在夏威夷，医疗补助人口更年轻，受教育程度更低，健康受损更多，并且比非医疗补助人口更有可能肥胖和夏威夷土著/其他太平洋岛民（NH/OPI）。夏威夷医疗补助人群中未调整的糖尿病患病率高于非医疗补助人群（10.3% vs 8.9%，P = 0.02）。在调整混杂变量后，医疗补助人群中糖尿病的几率仍然显著高于非医疗补助人群（调整后的比值比[AOR] = 1.75; 95%置信区间[CI]，1.33-2.31）。按种族/民族分层的调整后分析显示，非西班牙裔亚洲人（AOR = 2.23; 95% CI，1.31-3.78）和NH/OPI（AOR = 3.17; 95% CI，1.05-9.54）医疗补助受益人患糖尿病的几率显著高于非医疗补助受益人。糖尿病的几率显着高于夏威夷医疗补助人群比非医疗补助人群。糖尿病预防计划应该解决医疗补助人群面临的挑战和障碍。我们的研究结果可用于促进文化能力的糖尿病教育计划。
Medicaid is the largest primary health insurance for low-income populations in the United States, and it provides comprehensive benefits to cover treatment and services costs for chronic diseases, including diabetes. The standardized per capita spending on diabetes by Medicare beneficiaries enrolled in the fee-for-service program in Hawaii increased from 2012 to 2015. We examined the difference in odds of diabetes between Medicaid and non-Medicaid populations in major racial/ethnic groups in Hawaii. We used data from 2013 through 2015 from the Hawaii Behavioral Risk Factor Surveillance System in this cross-sectional study to compare the difference in risk for self-reported diabetes between Medicaid (n = 1,889) and non-Medicaid (n = 17,207) beneficiaries. We used multivariate logistic regression models that could accommodate the complex sampling design to examine the difference in odds of diabetes between the 2 populations. In Hawaii, the Medicaid population was younger, was less educated, had more health impairments, and was more likely to be obese and Native Hawaiian/Other Pacific Islander (NH/OPI) than the non-Medicaid population. The unadjusted prevalence of diabetes in the Medicaid population in Hawaii was higher than that for the non-Medicaid population (10.3% vs 8.9%, P = .02). After adjusting for confounding variables, the odds of diabetes in the Medicaid population was still significantly higher than those in the non-Medicaid population (adjusted odds ratio [AOR] = 1.75; 95% confidence interval [CI], 1.33–2.31). Adjusted analysis stratified by race/ethnicity showed that non-Hispanic Asian (AOR = 2.23; 95% CI, 1.31–3.78) and NH/OPI (AOR = 3.17; 95% CI, 1.05–9.54) Medicaid beneficiaries had significantly higher odds of diabetes than their non-Medicaid counterparts. The odds of diabetes was significantly higher among the Hawaii Medicaid population than among the non-Medicaid population. Diabetes prevention programs should address the challenges and barriers that the Medicaid population faces. Our findings can be used to promote culturally competent diabetes education programs.
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影响因子：
--
作者：
Bursac, Zoran;Gauss, C Heath;Williams, David Keith;Hosmer, David W
通讯作者：
Hosmer, David W
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影响因子：
3.9
作者：
Kaholokula JK;Look M;Mabellos T;Zhang G;de Silva M;Yoshimura S;Solatorio C;Wills T;Seto TB;Sinclair KA
通讯作者：
Sinclair KA
影响因子：
3.6
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Kaholokula, J. K.;Wilson, R. E.;Townsend, C. K. M.;Zhang, G. X.;Chen, J.;Yoshimura, S. R.;Dillard, A.;Yokota, J. W.;Palakiko, D. M.;Gamiao, S.;Hughes, C. K.;Kekauoha, B. K.;Mau, M. K.
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Mau, M. K.
影响因子：
120.7
作者：
Menke, Andy;Casagrande, Sarah;Cowie, Catherine C.
通讯作者：
Cowie, Catherine C.
影响因子：
4.6
作者：
Finger, Brooke;Brase, Jason;Flynn, Brigid C.
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Flynn, Brigid C.