Out-of-pocket costs and diabetes preventive services: the Translating Research Into Action for Diabetes (TRIAD) study.

摘要: OBJECTIVE —Despite the increased shifting of health care costs to consumers, little is known about impact financial barriers on utilization. This study investigated effect out-of-pocket expenditures utilization recommended diabetes preventive services. RESEARCH DESIGN AND METHODS —This was a survey-based observational (2000–2001) in 10 managed plans and 68 provider groups across U.S. serving ∼180,000 patients with diabetes. From 11,922 diabetic survey respondents, we studied occurrence self-reported annual dilated eye exams education among insulin users, daily self-monitoring blood glucose (SMBG). Conditional probabilities were estimated for outcomes at each level expenditure by using hierarchical logistic regression models random intercepts. RESULTS —Conditional (95% CI) varied exam [no cost 78% (75–82), copay 79% full price 70% (64–75); P CONCLUSIONS —Benefit packages structured derive greater fiscal contribution from plan membership result suboptimal use services may thus lead poorer clinical outcomes, future costs, lower quality ratings.