Higher Insurance Deductibles Problematic for Diabetes Care

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Specialty and emergency department visits decreased for higher-income respondents with a low deductible.
Specialty and emergency department visits decreased for higher-income respondents with a low deductible.

HealthDay News – Lower-income patients with diabetes and private insurance with a low (LD) or high deductible (HD) have reduced medical service use, according to a study published online in Diabetes Care.

David L. Rabin, MD, MPH, from the Georgetown University School of Medicine in Washington, DC, and colleagues used the 2011 to 2013 Medical Expenditure Panel Survey to compare demographic characteristics, medical service use, diabetes care, and health status among 1461 privately-insured adult respondents with diabetes (aged 18 to 64 years) by lower and higher income and deductible vs no deductible (ND), LD, and HD.

The researchers found that privately-insured lower-income respondents with an LD reported significant decreases in service use for primary care, check-ups, and specialty visits (27%, 39%, and 77% lower, respectively) compared with those with diabetes with ND; among respondents with an HD the decreases were 42%, 65%, and 86%, respectively. Significant decreases were seen in specialty and emergency department visits for higher-income respondents with an LD (28% and 37%, respectively). Diabetes care measures were similar by income and insurance, and no changes were seen in physical health status.

"Private insurance with a deductible substantially and problematically reduces medical service use for lower-income insured respondents with diabetes who have an HD; these patients are more likely to report forgoing needed medical services," the authors wrote.

Reference

Rabin DL, Jetty A, Petterson S, Saqr Z, Froehlich A. Among low-income respondents with diabetes, high-deductible vs no-deductible insurance sharply reduces medical service use [Published online December 9, 2016]. Diabetes Care. doi:10.2336.dc16-1579.

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