Details:

Alternative Title:
Prev Chronic Dis
Personal Author:
Ng, Boon Peng ; LaManna, Jacqueline B. ; Towne, Samuel D. ; Peach, Brian C. ; He, Qing ; ... More +
Ng, Boon Peng ; LaManna, Jacqueline B. ; Towne, Samuel D. ; Peach, Brian C. ; He, Qing ; Park, Chanhyun Less -
Description:
Introduction

Health care avoidance by Medicare beneficiaries with chronic conditions such as type 2 diabetes can result in adverse health and economic outcomes. The objective of this study was to describe factors associated with choices to avoid health care among Medicare beneficiaries with type 2 diabetes.

Methods

We used a survey-weighted logistic model and the nationally representative 2016 Medicare Current Beneficiary Survey to analyze data on 1,782 Medicare beneficiaries aged ≥65 with type 2 diabetes, to examine associations between Medicare beneficiaries’ decisions to avoid health care and multiple factors (eg, dissatisfaction with information given by providers, health problems that should have been discussed with providers but were not, worry about health more than other people their age).

Results

Of our study sample, 26.1% reported they avoid health care. Five factors were associated with avoiding health care: delaying care (vs not) because of costs (adjusted odds ratio [aOR] = 2.06; P = .005); having health problems that should have been discussed with providers but were not (vs having discussions) (aOR = 1.50; P = .04); worrying (vs not) about health more than other people their age (aOR = 2.13; P < .001); self-reporting “other” minority race (vs non-Hispanic White) (aOR = 2.01; P = .006); and education levels. Participants with less than a high school diploma (aOR = 1.95; P = .001) and participants with a high school diploma only (aOR = 1.49; P = .049) were more likely than participants with an education beyond high school to report avoiding health care.

Conclusion

Approximately 1 in 4 Medicare beneficiaries with type 2 diabetes avoid health care. We found inequities in care-seeking behavior by race/ethnicity and education level. Health care perceptions and lack of appropriate discussion of health care concerns with health care providers are also associated with this behavior. Clinical interventions (eg, improved patient–provider communication) and educational outreach are needed to decrease the numbers of Medicare beneficiaries who avoid health care.


Subjects:
[+]
Original Research
Source:
Prev Chronic Dis. 2020; 17
Pubmed ID:
33059795
Pubmed Central ID:
PMC7587306
Document Type:
Journal Article
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:5c455b2a4b8251d154f19af89f939db3b1431576ad8297513f38806c6af63797
Download URL:
https://stacks.cdc.gov/view/cdc/96044/cdc_96044_DS1.pdf
File Type:

Supporting Files

• PCD-17-E128.nxml

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