Disparities in Diabetes Self-management Education for Uninsured and Underinsured Adults

Kathy Shaw, Maureen Killeen, Erin Sullivan, Patricia Smith Bowman

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose To examine accessibility, availability, and quality of diabetes self-management education (DSME) for uninsured adults or those utilizing Medicaid in a community with a high poverty rate. Methods A descriptive needs assessment was conducted in 8 health care agencies serving the uninsured. Face-to-face audiotaped interviews were conducted with 22 health care providers, educators, and administrators to capture descriptive characteristics about clinical care, DSME, continuity of care, and organizational function. Results Twenty-nine percent of adults with diabetes were reported to be uninsured or utilizing Medicaid in these settings. Only 4% of adults received the American Diabetes Association's DSME standards of care. At 5 agencies, there was no direct access to DSME. Uninsured individuals had access to 2 programs; individuals utilizing Medicaid had access to 1 program. Certified diabetes educators were available at only 3 agencies. There were DSME programs that adhered to recommended guidelines but limited availability for these adults. The majority of education (86%) was limited to clinical encounters with providers, which were infrequent and variable in duration. Time spent on education ranged from 2 to 120 minutes depending on agency type. Education topics addressed by providers varied by agency. Conclusions Findings of this study suggest that adults who are utilizing Medicaid or are uninsured do not get the amount, type, or quality of DSME needed to sustain successful self-management. Limited availability and inadequate access to quality DSME place vulnerable adults at increased risk for devastating and costly complications despite the known benefits.

Original languageEnglish (US)
Pages (from-to)813-819
Number of pages7
JournalThe Diabetes Educator
Volume37
Issue number6
DOIs
StatePublished - Jan 1 2011

Fingerprint

Self Care
Education
Medicaid
Continuity of Patient Care
Needs Assessment
Poverty
Standard of Care
Administrative Personnel
Health Personnel
Guidelines
Interviews
Delivery of Health Care

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Health Professions (miscellaneous)

Cite this

Disparities in Diabetes Self-management Education for Uninsured and Underinsured Adults. / Shaw, Kathy; Killeen, Maureen; Sullivan, Erin; Bowman, Patricia Smith.

In: The Diabetes Educator, Vol. 37, No. 6, 01.01.2011, p. 813-819.

Research output: Contribution to journalArticle

Shaw, Kathy ; Killeen, Maureen ; Sullivan, Erin ; Bowman, Patricia Smith. / Disparities in Diabetes Self-management Education for Uninsured and Underinsured Adults. In: The Diabetes Educator. 2011 ; Vol. 37, No. 6. pp. 813-819.
@article{221d43a2ee2443b3aa854bfbb5a78c6b,
title = "Disparities in Diabetes Self-management Education for Uninsured and Underinsured Adults",
abstract = "Purpose To examine accessibility, availability, and quality of diabetes self-management education (DSME) for uninsured adults or those utilizing Medicaid in a community with a high poverty rate. Methods A descriptive needs assessment was conducted in 8 health care agencies serving the uninsured. Face-to-face audiotaped interviews were conducted with 22 health care providers, educators, and administrators to capture descriptive characteristics about clinical care, DSME, continuity of care, and organizational function. Results Twenty-nine percent of adults with diabetes were reported to be uninsured or utilizing Medicaid in these settings. Only 4{\%} of adults received the American Diabetes Association's DSME standards of care. At 5 agencies, there was no direct access to DSME. Uninsured individuals had access to 2 programs; individuals utilizing Medicaid had access to 1 program. Certified diabetes educators were available at only 3 agencies. There were DSME programs that adhered to recommended guidelines but limited availability for these adults. The majority of education (86{\%}) was limited to clinical encounters with providers, which were infrequent and variable in duration. Time spent on education ranged from 2 to 120 minutes depending on agency type. Education topics addressed by providers varied by agency. Conclusions Findings of this study suggest that adults who are utilizing Medicaid or are uninsured do not get the amount, type, or quality of DSME needed to sustain successful self-management. Limited availability and inadequate access to quality DSME place vulnerable adults at increased risk for devastating and costly complications despite the known benefits.",
author = "Kathy Shaw and Maureen Killeen and Erin Sullivan and Bowman, {Patricia Smith}",
year = "2011",
month = "1",
day = "1",
doi = "10.1177/0145721711424618",
language = "English (US)",
volume = "37",
pages = "813--819",
journal = "Diabetes Educator",
issn = "0145-7217",
publisher = "SAGE Publications Inc.",
number = "6",

}

TY - JOUR

T1 - Disparities in Diabetes Self-management Education for Uninsured and Underinsured Adults

AU - Shaw, Kathy

AU - Killeen, Maureen

AU - Sullivan, Erin

AU - Bowman, Patricia Smith

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Purpose To examine accessibility, availability, and quality of diabetes self-management education (DSME) for uninsured adults or those utilizing Medicaid in a community with a high poverty rate. Methods A descriptive needs assessment was conducted in 8 health care agencies serving the uninsured. Face-to-face audiotaped interviews were conducted with 22 health care providers, educators, and administrators to capture descriptive characteristics about clinical care, DSME, continuity of care, and organizational function. Results Twenty-nine percent of adults with diabetes were reported to be uninsured or utilizing Medicaid in these settings. Only 4% of adults received the American Diabetes Association's DSME standards of care. At 5 agencies, there was no direct access to DSME. Uninsured individuals had access to 2 programs; individuals utilizing Medicaid had access to 1 program. Certified diabetes educators were available at only 3 agencies. There were DSME programs that adhered to recommended guidelines but limited availability for these adults. The majority of education (86%) was limited to clinical encounters with providers, which were infrequent and variable in duration. Time spent on education ranged from 2 to 120 minutes depending on agency type. Education topics addressed by providers varied by agency. Conclusions Findings of this study suggest that adults who are utilizing Medicaid or are uninsured do not get the amount, type, or quality of DSME needed to sustain successful self-management. Limited availability and inadequate access to quality DSME place vulnerable adults at increased risk for devastating and costly complications despite the known benefits.

AB - Purpose To examine accessibility, availability, and quality of diabetes self-management education (DSME) for uninsured adults or those utilizing Medicaid in a community with a high poverty rate. Methods A descriptive needs assessment was conducted in 8 health care agencies serving the uninsured. Face-to-face audiotaped interviews were conducted with 22 health care providers, educators, and administrators to capture descriptive characteristics about clinical care, DSME, continuity of care, and organizational function. Results Twenty-nine percent of adults with diabetes were reported to be uninsured or utilizing Medicaid in these settings. Only 4% of adults received the American Diabetes Association's DSME standards of care. At 5 agencies, there was no direct access to DSME. Uninsured individuals had access to 2 programs; individuals utilizing Medicaid had access to 1 program. Certified diabetes educators were available at only 3 agencies. There were DSME programs that adhered to recommended guidelines but limited availability for these adults. The majority of education (86%) was limited to clinical encounters with providers, which were infrequent and variable in duration. Time spent on education ranged from 2 to 120 minutes depending on agency type. Education topics addressed by providers varied by agency. Conclusions Findings of this study suggest that adults who are utilizing Medicaid or are uninsured do not get the amount, type, or quality of DSME needed to sustain successful self-management. Limited availability and inadequate access to quality DSME place vulnerable adults at increased risk for devastating and costly complications despite the known benefits.

UR - http://www.scopus.com/inward/record.url?scp=80755126077&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80755126077&partnerID=8YFLogxK

U2 - 10.1177/0145721711424618

DO - 10.1177/0145721711424618

M3 - Article

C2 - 22021026

AN - SCOPUS:80755126077

VL - 37

SP - 813

EP - 819

JO - Diabetes Educator

JF - Diabetes Educator

SN - 0145-7217

IS - 6

ER -