Impact of Emerging Health Insurance Arrangements on Diabetes Outcomes and Disparities: Rationale and Study Design

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Wharam, J. Frank ; Soumerai, Steve ; Trinacty, Connie ; Eggleston, Emma ; Zhang, Fang ; LeCates, Robert ; Canning, Claire ; Ross-Degnan, Dennis
• Description:
  Consumer-directed health plans combine lower premiums with high annual deductibles, Internet-based quality-of-care information, and health savings mechanisms. These plans may encourage members to seek better value for health expenditures but may also decrease essential care. The expansion of high-deductible health plans (HDHPs) represents a natural experiment of tremendous proportion. We designed a pre-post, longitudinal, quasi-experimental study to determine the effect of HDHPs on diabetes quality of care, outcomes, and disparities. We will use a 13-year rolling sample (2001-2013) of members of an HDHP and members of a control group. To reduce selection bias, we will limit participants to those whose employers mandate a single health insurance type. The study will measure rates of monthly hemoglobin A1c, lipid, and albuminuria testing; availability of blood glucose test strips; and rates of retinal examinations, high-severity emergency department visits, and preventable hospitalizations. Results could be used to design health plan features that promote high-quality care and better outcomes among people who have diabetes.
• Subjects:
  Adolescent Adult Aged Antihypertensive Agents Diabetes Mellitus Evidence-Based Practice Female Health Benefit Plans, Employee Health Services Accessibility Health Status Disparities Humans Hypoglycemic Agents Linear Models Longitudinal Studies Male Middle Aged Outcome Assessment (Health Care) Quality Of Health Care Research Design Retrospective Studies Socioeconomic Factors

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• Source:
  Prev Chronic Dis. 10.
• DOI:
  http://dx.doi.org/10.5888/pcd10.120147
• ISSN:
  1545-1151
• Pubmed ID:
  23369764
• Pubmed Central ID:
  PMC3562172
• Document Type:
  Journal Article
• Funding:
  U58 DP002717/DP/NCCDPHP CDC HHS/United States
• Place as Subject:
  United States
• Location:
  North America
• Volume:
  10
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:f70a1927dc917298dc01fcb905f1fafaa0f5aee6ba29173e5fb4e7f82a846f6263a795a4cdd198e445605ee4c03cdaee6c7acd81ad50247aac86cc5089aaafc3
• Download URL:
  https://stacks.cdc.gov/view/cdc/19622/cdc_19622_DS1.pdf
• File Type:
  [PDF - 164.12 KB ]