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Affordable health care means better access to diabetes prevention, management

OHSU study compares rates of health care utilization at Community Health Centers in states with, without Medicaid expansion programs
 person in doctors coat shown from shoulders down, taking blood sugar measurement from a hand.
A new study shows that access to affordable healthcare yields more successful management of chronic conditions such as diabetes. (Getty Images)

According to the Centers for Disease Control and Prevention, more than 100 million Americans are either living with diabetes or have higher than average blood sugar levels consistent with prediabetes.

Management of these chronic conditions requires consistent monitoring of blood sugar levels, robust medication regimens and frequent health care appointments, all of which take time, resources and money. Because of these barriers, many Americans with diabetes often go undiagnosed or ignore necessary treatment options altogether.

A study published online in the Journal of the American Board of Family Medicine has confirmed one way to ensure broader usage of preventive and disease management services for diabetes patients: access to affordable health care.

Nathalie Huguet, Ph.D.
Nathalie Huguet, Ph.D.

Using electronic health record data, Nathalie Huguet, Ph.D., and a team of researchers at OHSU in Portland, Oregon, compared changes in insurance and primary care visit rates among patients diagnosed with diabetes or prediabetes, and individuals with no diagnosis. Patients received care at community health centers in 13 U.S. states, nine of which have Medicaid expansion programs.

Researchers found that the rates of uninsured visits to Community Health Centers decreased in all states across the three patient groups. Further, consistent with national averages, patients previously diagnosed with diabetes had higher clinic visit rates when compared with prediabetes or undiagnosed patients.  

While the researchers did not find an overall increase in visits among this population, Huguet, a research assistant professor of family medicine in the OHSU School of Medicine, says that due to higher rates of obtained insurance, many  patients were able to receive critical treatments and services, including preventive screenings, lab testing, specialized care and some medication not accessible to them before.

“This is particularly true for patients with lower socioeconomic status,” she said. “The utilization rates of these services prove how critical programs such as the Affordable Care Act and Medicaid Expansion are to a growing and vulnerable patient population.”

This research was supported by the U.S. Centers for Disease Control and Prevention; the National Institute of Diabetes and Digestive and Kidney Disease (U18DP006116) and the National Cancer Institute (R01CA204267, R01CA181452), both components of the National Institutes of Health; and the Agency for Healthcare Research and Quality (R01HS024270).

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