A 3-State Analysis of Black–White Disparities in Diabetes Hospitalizations Among Medicaid Beneficiaries

Abstract

Introduction:Although diabetes is one of the leading chronic disease in the country, efforts in primary care and patient self-care management could prevent most of the diabetes-related hospitalizations and produce cost savings and improvements in quality of life. We used information from Medicaid beneficiaries in 3 states to predict racial differences in diabetes hospitalizations and demonstrate how they vary across states.Methods:We conducted a cross-sectional study to examine differences between black and white patients with diabetes hospitalizations. Information was obtained from the Medicaid Analytic eXtract files. We used multiple logistic regression models to assess the significance of the differences.Results:Analysis included 10 073 adult Medicaid recipients from the states of Mississippi (51%), Georgia (35%), and Michigan (14%). Blacks were more likely to experience longer hospital stays in Georgia (odds ratio [OR] = 1.040; 95% confidence interval [CI]: 1.03-1.06) and Mississippi (OR = 1.048; 95% CI: 1.03-1.07). A majority of patients in both groups were likely to be discharged to their homes for self-care. Black patients had lower odds of repeated stays in Georgia (OR = 0.670; 95% CI: 0.54-0.84), but higher odds in Michigan (OR = 1.580; 95% CI: 1.12-2.24). Similar differences occurred when patients were matched by age and sex. Blacks had lower odds of qualifying for dual Medicare–Medicaid enrollment benefit in Georgia and Mississippi.Conclusion:Racial differences in diabetes-related hospitalizations reflect possible inefficiencies in the process of care. Identification of race-specific factors for hospitalizations and implementation of primary care strategies that support effective self-management skills would aid in reducing diabetes hospitalizations and related disparities.

Trends and best practices in health care cybersecurity insurance policy

“…Such bankruptcies could worsen the health disparities that already exist among these populations. 25 Furthermore, policymakers should promote cybersecurity insurance since it could be used as a tool for improving cybersecurity that protects valuable patient information. This is because insurance companies can offer lower premiums for hospitals as an incentive for meeting certain security requirements.…”

“…These organizations could be forced to close because of a cyberbreach, leaving their former patient population with much more limited access to care. Such bankruptcies could worsen the health disparities that already exist among these populations 25 . Furthermore, policymakers should promote cybersecurity insurance since it could be used as a tool for improving cybersecurity that protects valuable patient information.…”

Understanding Type 2 Diabetes Self-Management in Racial/Ethnic Minorities: Application of the Extended Parallel Processing Model and Sensemaking Theory in a Qualitative Study

“…1-3 Diabetes self-management is important for achieving and maintaining glycemic stability to avoid these complications, 4 but racial/ethnic minorities also tend to have lower adherence to self-management behaviors than nonminorities. 5,6 Several reasons have been suggested for this adherence gap, including psychological factors, social determinants of health, and lower health literacy. 7,8 Risk perception may also affect perceived importance of self-management behaviors among people with T2DM.…”