Objective
To compare the quality of care by insurance type in federally-funded community health centers (HC).
Method
A total of 2,018 diabetes patients, randomly selected from 27 HCs in 17 states in the year 2002, were categorized into six mutually exclusive insurance groups. Quality of diabetes care, using six National Committee for Quality Assurance (NCQA) Health Plan Employer Data and Information Set (HEDIS) diabetes processes of care and outcome measures, were compared using multivariate logistic regression analyses.
Results
Thirty-three percent of patients had no health insurance, 24% had Medicare without Medicaid, 15% Medicaid without Medicare, 7% were Medicare-Medicaid dual eligibles, 14% had private insurance, and 7% had other type of insurance. Those without insurance were least likely to meet the HEDIS quality-of-care measures, and those with Medicaid had quality of care that was very similar to those with no insurance.
Conclusion
Research is needed to identify the major mediators of differences in quality of care by insurance status in safety-net providers such as HCs, for policy interventions at Medicaid benefit design, and incentive to improve quality of care.
This study1 focuses on Hispanic migrant farmworkers and their perceptions of living with diabetes. A phenomenological design was utilized with a sample of 12 participants recruited from 2 local migrant health centers. The interview guide was based on questions from Kleinman's Explanatory Model. Data were explored with regard to etiology, onset of symptoms, pathophysiology, and course of illness. Six themes emerged from the analysis: usualness of diabetes, causes of diabetes, symptoms prior to the diagnosis of diabetes, understanding the chronicity of diabetes, impact of diabetes on daily life, and fear of long-term complications related to diabetes. Based on the analysis of the interviews, the individuals' explanations of this chronic disease are compiled within their own perceptions and cultural beliefs. The results of this study can be utilized by providers to adapt their health care and education methods to better meet the needs of this mobile population. In the Hispanic migrant farmworker population, further research is needed to explore the long-term impact of living with diabetes on a daily basis.
Training in health literacy is associated with increased usage of evidence-based techniques to assist patients with LHL. Providers at all levels would likely benefit from LHL training. Most providers believe providing health education materials designed specifically for patients with LHL would be very helpful.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.