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330666
Patient utilization of diabetes screening services under the Affordable Care Act of 2010


Tuesday, November 3, 2015

Siyoung Choe, MPH, Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN
Hsien-Chang Lin, PhD, MA, Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN
Dong-Chul Seo, PhD, Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN
Background: The Affordable Care Act (ACA) is a comprehensive health insurance reform enacted in 2010. Under ACA, diabetes screening is one of the 15 essential preventive services, allowing diabetes screening without any copay. This study conducted an initial assessment of the ACA on patient utilization of diabetes screening services (DSS).

Methods: A multi-year cross-sectional study was conducted using the 2008-2012 Behavioral Risk Factor Surveillance System survey. Non-pregnant adults with no physical/cognitive impairment were included for analyses (N=1,667,725). Andersen Model of Health Care Utilization was used for conceptual framework. Logistic regression with year-fixed effects was performed to examine the associations between socio-demographic characteristics and DSS utilization.

Results: About 9.4% of the participants were diagnosed with diabetes, and 59.0% indicated DSS utilization. Logistic regression showed that odds of utilizing DSS did not significantly increase by year after the ACA implementation. The higher the perceived cost barriers and general health status, the lower the DSS utilization (both ORs=0.91, both ps < 0.001). Older age (OR=1.32), having an insurance (OR=1.65), female (OR=1.11), racial/ethnic minorities (OR=1.17-1.78, compared with non-Hispanic whites), married (OR=1.20), more education years (OR=1.09), higher income (OR=1.08), and being pre/borderline diabetic (OR=1.69) were all positively associated with DSS utilization (all ps < 0.001).

Conclusion: Results from this study indicate that initial implementation of ACA had no effect on DSS utilization, although further evaluations are warranted for a fully-fledged ACA. Efforts to enhance DSS utilization should consider disparities among different socio-demographic groups.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss patient utilization of diabetes screening services under the Affordable Care Act

Keyword(s): Affordable Care Act

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as a Program Coordinator at the Indiana State Department of Health. Three of my studies were presented at national academic conferences, two of which evaluated the effect of preventive services under the Affordble Care Act. I have also co-authored a manuscript published in the American Journal of Health Behavior, and my research interests include health policy evaluation and chronic disease epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4182.0: Behavioral Science/ Health Education Poster Session #2