title: Healthcare utilization and diabetes management programs: Indiana 2006-2010.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.forename: Tilicia L
authors.initials: TL
authors.lastname: Mayo-Gamble
authors.affiliation: Indiana University, Department of Applied Health Science, 1025 E 7th St, Ste 116, Bloomington, IN 47405. E-mail: linhsi@indiana.edu.
authors.forename: Hsien-Chang
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007196:Indiana; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D016012:Poisson Distribution; D011584:Psychology; D012189:Retrospective Studies; D012648:Self Care / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D007328:Insulin