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Access to care by Medicare beneficiaries in the U.S. with diabetes and multiple chronic conditions during the COVID-19 pandemic.
Clements, John M.
  • Clements JM; Michigan State University, College of Human Medicine, Division of Public Health, 130 E 2nd Street, Flint, MI 48502, United States of America. Electronic address: clemen69@msu.edu.
J Diabetes Complications ; 36(12): 108355, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2105322
ABSTRACT

OBJECTIVE:

Determine characteristics of Medicare beneficiaries with diabetes and multiple chronic conditions (MCC) associated with being unable to obtain medical services during COVID-19. RESEARCH DESIGN AND

METHODS:

Retrospective cohort study of data from COVID-19 Supplements of Medicare Current Beneficiary Surveys administered in Summer (N = 11,114, unweighted) and Fall (N = 9686, unweighted) 2020, and Winter 2021 (N = 11,107, unweighted). Binary logistic regression was used to model for adjusted odds of self-reports of being unable to access different types of care.

RESULTS:

In three time periods from March 2020 through March/April 2021 beneficiaries with diabetes plus MCC combinations reported being unable to get medical care, compared to beneficiaries with diabetes alone. Notably, patterns persisted at the 12-month mark with beneficiaries with diabetes plus cancer (OR = 1.24), and diabetes plus cancer/stroke (OR = 2.53) experiencing increased odds of being unable to get care because of COVID-19, compared to beneficiaries with diabetes alone. By March/April 2021 beneficiaries with diabetes plus COPD (OR = 1.08), diabetes plus stroke (OR = 1.49), and diabetes plus Alzheimer's (OR = 1.09) experienced increased odds of being unable to get treatment for ongoing conditions. Beneficiaries with diabetes plus Alzheimer's (OR = 1.40) also experienced increased odds of being unable to get a regular check-up 12 months into the pandemic. Finally, members of racial/ethnic minority groups experienced increased odds of being unable to obtain services at various times during the pandemic compared to non-Hispanic Whites, with increased odds persisting at 12 months for non-Hispanic Blacks and Hispanics.

CONCLUSIONS:

Beneficiaries with MCC, and minorities, experienced increased odds of being unable to obtain some services during COVID-19, even when controlling for similar diabetes and MCC combinations. Work remains for providers and public health systems to dismantle and reimagine systems to provide equitable access to care.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / Diabetes Mellitus / Alzheimer Disease / Multiple Chronic Conditions / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Humans Country/Region as subject: North America Language: English Journal: J Diabetes Complications Journal subject: Endocrinology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / Diabetes Mellitus / Alzheimer Disease / Multiple Chronic Conditions / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Humans Country/Region as subject: North America Language: English Journal: J Diabetes Complications Journal subject: Endocrinology Year: 2022 Document Type: Article