title: Insurance-related disparities in primary care quality among U.S. Type 2 diabetes patients.
abstract: This study explored insurance-related disparities in primary care quality among Americans with type 2 diabetes.
  
  
  
  Data came from the household component of the 2012 Medical Expenditure Panel Survey (MEPS). Analysis focused on adult subjects with type 2 diabetes. Logistic regressions were performed to investigate the associations between insurance status and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, while controlling for confounding factors.
  
  
  
  Preliminary findings revealed differences among three insurance groups in the first contact domain of primary care quality. After controlling for confounding factors, these differences were no longer apparent, with all insurance groups reporting similar primary care quality according to the four domains of interest in the study. There were significant differences in socioeconomic status among different insurance groups.
  
  
  
  This study reveals equitable primary care quality for diabetes patients despite their health insurance status. In addition to insurance-related differences, the other socioeconomic stratification factors are assumed to be the root cause of disparities in care. This research emphasizes the crucial role that primary care plays in the accessibility and quality of care for chronically ill patients. Policy makers should continue their commitment to reduce gaps in insurance coverage and improve access as well as quality of diabetic care.
authors.affiliation: Johns Hopkins Primary Care Policy Center, Baltimore, MD, 21205, USA.|Department of Information Management, Da-Yeh University, No. 168, University Rd., Dacun, Changhua, 51591, Taiwan, Republic of China.
authors.forename: De-Chih
authors.initials: DC
authors.lastname: Lee
authors.affiliation: Johns Hopkins Primary Care Policy Center, Baltimore, MD, 21205, USA.|Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
authors.forename: Hailun
authors.initials: H
authors.lastname: Liang
authors.affiliation: Johns Hopkins Primary Care Policy Center, Baltimore, MD, 21205, USA. lshi2@jhu.edu.|Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA. lshi2@jhu.edu.
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration*; D012923:Social Class; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
keywords: Diabetes; Insurance-related disparities; Primary care quality