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Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012

INTRODUCTION: Lack of health insurance is a barrier to medical care, which may increase the risk of diabetes complications and costs. The objective of this study was to assess the potential of the Affordable Care Act (ACA) of 2010 to improve diabetes care through increased health care access by comp...

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Autores principales: Brown, Derek S., McBride, Timothy D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Centers for Disease Control and Prevention 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436040/
https://www.ncbi.nlm.nih.gov/pubmed/25950571
http://dx.doi.org/10.5888/pcd12.140431
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author Brown, Derek S.
McBride, Timothy D.
author_facet Brown, Derek S.
McBride, Timothy D.
author_sort Brown, Derek S.
collection PubMed
description INTRODUCTION: Lack of health insurance is a barrier to medical care, which may increase the risk of diabetes complications and costs. The objective of this study was to assess the potential of the Affordable Care Act (ACA) of 2010 to improve diabetes care through increased health care access by comparing health care and health outcomes of insured and uninsured people with diabetes. METHODS: We examined demographics, access to care, health care use, and health care expenditures of adults aged 19 to 64 years with diabetes by using the 2011 and 2012 Medical Expenditure Panel Survey. Bivariate descriptive statistics comparing insured and uninsured persons were evaluated separately by income above and below 138% of the federal poverty level (FPL), (a threshold for expanded Medicaid eligibility in select states under the ACA) using the t test and proportion and median tests. RESULTS: Uninsured adults reported poorer access to care than insured adults, such as having a usual source of health care (69.0% vs 89.5% [≤138% FPL], 77.1% vs 94.6% [>138% FPL], both P < .001) and having lower rates of 6 key diabetes preventive care services (P ≤ .05). Insured adults with diabetes had significantly higher health care expenditures than uninsured adults ($13,706 vs $4,367, $10,838 vs $4,419, respectively, both P < .001). CONCLUSION: Uninsured adults with diabetes had less access to health care and lower levels of preventive care, health care use, and expenditures than insured adults. To the extent that the ACA increases access and coverage, uninsured people with diabetes are likely to significantly increase their health care use, which may lead to reduced incidence of diabetes complications and improved health.
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spelling pubmed-44360402015-06-02 Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012 Brown, Derek S. McBride, Timothy D. Prev Chronic Dis Original Research INTRODUCTION: Lack of health insurance is a barrier to medical care, which may increase the risk of diabetes complications and costs. The objective of this study was to assess the potential of the Affordable Care Act (ACA) of 2010 to improve diabetes care through increased health care access by comparing health care and health outcomes of insured and uninsured people with diabetes. METHODS: We examined demographics, access to care, health care use, and health care expenditures of adults aged 19 to 64 years with diabetes by using the 2011 and 2012 Medical Expenditure Panel Survey. Bivariate descriptive statistics comparing insured and uninsured persons were evaluated separately by income above and below 138% of the federal poverty level (FPL), (a threshold for expanded Medicaid eligibility in select states under the ACA) using the t test and proportion and median tests. RESULTS: Uninsured adults reported poorer access to care than insured adults, such as having a usual source of health care (69.0% vs 89.5% [≤138% FPL], 77.1% vs 94.6% [>138% FPL], both P < .001) and having lower rates of 6 key diabetes preventive care services (P ≤ .05). Insured adults with diabetes had significantly higher health care expenditures than uninsured adults ($13,706 vs $4,367, $10,838 vs $4,419, respectively, both P < .001). CONCLUSION: Uninsured adults with diabetes had less access to health care and lower levels of preventive care, health care use, and expenditures than insured adults. To the extent that the ACA increases access and coverage, uninsured people with diabetes are likely to significantly increase their health care use, which may lead to reduced incidence of diabetes complications and improved health. Centers for Disease Control and Prevention 2015-05-07 /pmc/articles/PMC4436040/ /pubmed/25950571 http://dx.doi.org/10.5888/pcd12.140431 Text en https://creativecommons.org/licenses/by/4.0/This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
spellingShingle Original Research
Brown, Derek S.
McBride, Timothy D.
Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012
title Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012
title_full Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012
title_fullStr Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012
title_full_unstemmed Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012
title_short Impact of the Affordable Care Act on Access to Care for US Adults With Diabetes, 2011–2012
title_sort impact of the affordable care act on access to care for us adults with diabetes, 2011–2012
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436040/
https://www.ncbi.nlm.nih.gov/pubmed/25950571
http://dx.doi.org/10.5888/pcd12.140431
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