Healthcare Utilization and Diabetes Management Programs: Indiana 2006-2010

Objectives: Healthcare utilization and participation in diabetes management programs have shown to be beneficial to overall health in patients with type 2 diabetes mellitus (T2DM). To improve the effectiveness of healthcare activities on diabetes health outcomes, factors associated with healthcare activities such as physician seeking and participating in a diabetes management class need to be identified.

Design and Methods: A retrospective multi-year cross-sectional analysis was conducted. Data were collected using data sets from the 2006 to 2010 Behavioral Risk Factor Surveillance System Survey. A Poisson regression was conducted to capture the influence of predisposing, enabling, and need factors on the number of physician visits for diabetes. A logistic regression was conducted to capture the influence of the aforementioned factors on participation in a diabetes management class.

Results: Results of the Poisson regression indicate patients who were taking insulin, more frequently check for sores, or have hemoglobin exams, had made more physician visits (incident rate ratios = 1.34, 1.04, and 1.05, respectively; all P <.01). Results of the logistic regression indicate patients who were taking insulin or more frequently check for sores (odds ratio [OR] = 1.48, 1.37, 1.43, 0.74, 1.30, 1.07, and 1.06, respectively; all P <.01), were more likely to participate in a diabetes management class. Results also indicated patients who were male or married were less likely to participate in a diabetes management class (OR = 0.69, P <.05; OR = 0.81, P <.01 respectively).

Conclusions: Evidence supports sociological factors as important facilitators promoting healthcare utilization in patients with increased T2DM severity levels. Interventions to improve healthcare utilization should acknowledge sociological factors, particularly self-care factors.