Health services use and health status among people with diabetes mellitus and cardiovascular diseases

Diabetes Mellitus (DM) is one of the most prevalent chronic diseases in the US. People with DM have complex needs of health care due to higher risk of developing cardiovascular diseases (CVD) such as heart diseases and stroke than people without DM. Therefore DM has a great impact on people's health in the US. This study adopted the Andersen's Behavioral Model of Health Services Utilization as a framework to identify the association of health services uses and subsequent health outcomes within a representative sample of community-dwelling adults aged 51 years and older through a longitudinal analysis of the Health and Retirement Study data from 1998 through 2008. In this study, subjects were classified into four health groups (DM only, CVD only, DM+CVD, No-DM/CVD). Results showed that the association between nursing home use and activities of daily living (ADL), prescription drug use and instrumental activities of daily living (IADL), and home health care and self-rated health was found to be different by health groups. The use of nursing home was associated with increased odds of having prospective severe ADL limitation for the “DM only” group. Prescription drug use was associated with declined IADL for the “CVD only” group. However, in the “DM+CVD” group, home health care use was associated with not declined self-rated health. Our study findings can provide health care professionals and health care administrators the insight required for improving the health care practice and the quality of health care in the U.S.