BACKGROUND:This study explored insurance-related disparities in primary care quality among Americans with type 2 diabetes. METHODS:Data came from the household component of the 2012 Medical Expenditure Panel Survey (MEPS). Analysis focused on adult subjects with type 2 diabetes. Logistic regressions were performed to investigate the associations between insurance status and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, while controlling for confounding factors. RESULTS:Preliminary findings revealed differences among three insurance groups in the first contact domain of primary care quality. After controlling for confounding factors, these differences were no longer apparent, with all insurance groups reporting similar primary care quality according to the four domains of interest in the study. There were significant differences in socioeconomic status among different insurance groups. CONCLUSION:This study reveals equitable primary care quality for diabetes patients despite their health insurance status. In addition to insurance-related differences, the other socioeconomic stratification factors are assumed to be the root cause of disparities in care. This research emphasizes the crucial role that primary care plays in the accessibility and quality of care for chronically ill patients. Policy makers should continue their commitment to reduce gaps in insurance coverage and improve access as well as quality of diabetic care.

译文

背景:本研究探讨了美国2型糖尿病患者在保险方面的基本医疗质量差异。
方法:数据来自2012年医疗支出小组调查(MEPS)的家庭部分。分析集中于患有2型糖尿病的成人受试者。进行逻辑回归分析,以调查保险状况与与首次接触,纵向,全面性和协调性相关的初级保健属性之间的关联,同时控制混杂因素。
结果:初步发现显示,在初级保健质量的首次接触领域中,三个保险集团之间存在差异。在控制了混杂因素之后,这些差异不再明显,根据研究的四个领域,所有保险集团都报告了相似的初级保健质量。不同保险集团之间的社会经济地位存在显着差异。
结论:本研究揭示了尽管糖尿病患者具有健康保险状态,但他们仍享有公平的初级保健质量。除了与保险有关的差异外,其他社会经济分层因素也被认为是医疗服务差异的根本原因。这项研究强调了初级保健在慢性病患者的可及性和医疗质量中的关键作用。决策者应继续致力于减少保险覆盖率的差距,并改善糖尿病护理的可及性和质量。

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