Diabetes care: Does having a usual source of care improve health related behaviors?

Background: Having a usual source of care (USOC) is associated with acceptable and optimal glycemic levels in diabetic patients due to better adherence to medications. In addition, healthy diets and regular exercise are associated with better health outcomes in diabetic patients. The main objective of this study is to determine whether having a USOC influences health related behaviors (i.e. diet and physical activity) of adult diabetic patients. This study uses the structural equation modeling (SEM) approach to assess the direct and indirect effects of USOC on health related behaviors in such population. Methods: Data on 4,761 adult diabetics (excluding women with gestational diabetes) from the California Health Interview Survey (2009) were used to estimate a non-standard structural equations path model using EQS 6.2 to estimate the effects of having a USOC on the health related behaviors of the respondents. The outcome of interest was health behavior, a latent variable representing dietary and exercise habits. Primary regressor of interest was the utilization of a USOC. Control variables included age, education, gender, insurance status, family income and general health. Results: There were no significant direct effects of USOC on health behavior. Having health insurance was found to have a significant direct effect on health behaviors and was not significantly mediated by having a USOC. Conclusion: Having a USOC may not influence patients' life style choices unless there are additional efforts made on part of both providers and patients to improve and expand such relationships.