Methods: This study used 1994, 1996, and 1997 Missouri Behavioral Risk Factor Surveillance System data. Telephone interviews were conducted with 4,915 respondents, 266 of whom reported diabetes. Diabetes-related services were cross-tabulated with access to health care indicators and risk factor counseling. Confidence intervals on prevalence estimates were generated with SUDAAN.
Results: Among a segment of the population, patterns of under-utilization of diabetes-related services associated with barriers to health care and lower prevalence of risk factor counseling are present. Individuals with diabetes who have had less than two HbA1c tests (81%) and foot exams (46%) and have not had an eye exam (32%), dental exam (40%), and/or flu shot (57%) in the past year report barriers such as: no primary payer for medical services, cost, transportation, limited service, Medicare/Medicaid refusal, infrequent check-ups, lack of cholesterol screening and dissatisfaction with overall access to health care. Additionally, these individuals generally report higher prevalences of physical inactivity, inadequate fruit and vegetable consumption, smoking, and acute drinking; with lower prevalences of risk factor counseling regarding weight, diet, exercise, and smoking, factors associated with diabetes-related complications.
Conclusions: The most at-risk segment of those individuals with diabetes is not receiving an appropriate level of diabetes-related services or risk factor counseling. Public health initiatives should address those barriers that limit access for these individuals, improving the utilization of diabetes-related services.
Learning Objectives: Participants will learn to identify health care access barriers among individuals with diabetes for diabetes-related services and identify shortcomings in risk factor counseling.
Keywords: Diabetes,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.