Receipt of diabetes preventive care among safety net patients associated with differing levels of insurance coverage.
Receipt of diabetes preventive care among safety net patients associated with differing levels of insurance coverage.
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DOI：
10.3122/jabfm.2012.01.110142
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发表时间：
2012-01
期刊：
影响因子：
--
通讯作者：
Shah AR
中科院分区：
文献类型：
--
作者：
Gold R;DeVoe JE;McIntire PJ;Puro JE;Chauvie SL;Shah AR
无论保险状况如何，患者都在安全网诊所接受护理;然而，糖尿病预防护理的接受可能因保险连续性水平不同而异。在一项回顾性队列研究中，使用2005-2007年在俄勒冈州50家安全网诊所接受治疗的糖尿病成人电子健康记录数据，我们进行了调整后的logistic回归，以建立保险时间与接受血脂筛查、流感疫苗接种、肾病筛查（尿微量白蛋白）和糖尿病控制（糖化血红蛋白）筛查的比例之间的相关性模型。在3，384名糖尿病成年人中，711人“部分”投保（覆盖3年研究期的1-99%），909人没有保险，1，764人连续投保。在调整后的模型中，在3年的研究期间，部分覆盖或没有覆盖的人与连续覆盖的人相比，不太可能获得大多数预防服务。我们没有发现任何证据表明剂量-反应关系与覆盖时间的增加有关，也没有证据表明部分覆盖的阈值与更好的护理相关。安全网诊所的病人需要获得初级保健和连续保险。所有部分覆盖的患者，无论保险时间长短，接受预防性护理的几率都较低。
Patients receive care in safety net clinics regardless of insurance status; however, diabetes preventive care receipt might vary in patients with differing levels of insurance continuity. In a retrospective cohort study, using electronic health record data from adults with diabetes receiving care in 50 safety net clinics in Oregon in 2005–2007, we conducted adjusted logistic regressions to model the associations between amount of time with insurance and rates of receipt of lipid screening, influenza vaccination, nephropathy screening (urine microalbumin), and DM control (glycosylated hemoglobin) screening. Of 3,384 adults with diabetes, 711 were ‘partially’ insured (covered 1–99% of the 3-year study period), 909 had no coverage, and 1,764 were continuously insured. In adjusted models, persons with partial or no coverage during the 3-year study period were less likely to receive most preventive services, compared to those with continuous coverage. We found no evidence of a dose-response relationship with increasing duration of coverage, nor of a threshold amount of partial coverage, associated with better receipt of care. Safety net clinic patients need both access to primary care and continuous insurance. All patients with partial coverage, regardless of the extent of time with insurance, had lower odds of receiving preventive care.
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影响因子：
16.2
作者：
DeVoe JE;Tillotson CJ;Wallace LS
通讯作者：
Wallace LS
影响因子：
3.4
作者：
Nelson, KM;Chapko, MK;Boyko, EJ
通讯作者：
Boyko, EJ
影响因子：
158.5
作者：
Landon, Bruce E.;Hicks, LeRoi S.;Guadagnoli, Edward
通讯作者：
Guadagnoli, Edward
影响因子：
16.2
作者：
Srinivasan, M;Przybylski, M;Swigonski, N
通讯作者：
Swigonski, N
DOI：
10.3122/jabfm.2008.04.080001
发表时间：
2008-07-01
影响因子：
2.9
作者：
Voorhees, Kenton;Fernald, Douglas H.;Westfall, John M.
通讯作者：
Westfall, John M.