Does Health Status Differ by Healthcare Access in Diabetic Females Ages 45-79?

Abstract

Purpose: Healthcare access can impact health status in patients with diabetes, but research assessing healthcare access and health status in diabetic females is limited. The purpose of this study was to assess the relationship between health status (general, physical, and mental health) and healthcare access (coverage and cost) in diabetic females ages 45 to 79. Methods. This cross-sectional analysis used data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) for diabetic females ages 45 to 79 from Louisiana (N=594), Mississippi (N=541), Oklahoma (N=566), and Texas (N=1013). Multiple logistic regression and ordered logistic regression were conducted by state to determine the relationship between health status and healthcare access after controlling for health-related and demographic factors. Results. Across states, about half of diabetic females reported fair or poor general health (43-49%), low to moderate physical health (51-61%), and low to moderate mental health (39-45%). In addition, most reported having healthcare coverage (90-95%) and few reported that cost precluded doctor visits (16-22%). Adjusted analysis indicated that health status was related to healthcare cost, but not to coverage, across states. Those for whom cost precluded doctor visits were less likely to report higher levels of general, physical, and mental health. In addition, all health status variables were inversely related to having three or more health conditions. Also, general and physical health were inversely related to tobacco use across states. Conclusion. The results for diabetic females ages 45 to 79 indicated that health status was inversely related to healthcare cost and to having three or more comorbid health conditions, but not to healthcare coverage. Practitioners should screen all patients in the target population for multiple health conditions, determine severity and management, and educate patients on the importance of managing diabetes with comorbidities. Additionally, practitioners should be aware of how financial constraints can negatively impact patients’ health status, such as considering treatment costs when treating low income patients.