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Health Serv Res. 2018 Jun;53(3):1517-1538. doi: 10.1111/1475-6773.12644. Epub 2017 Jan 10.

Does Identification of Previously Undiagnosed Conditions Change Care-Seeking Behavior?

Author information

1
Department of Pharmaceutical and Health Economics, Leonard D. Schaeffer Center for Health Policy and Economics, The University of Southern California, Verna & Peter Dauterive Hall, Office 414E, 635 DowneyWay, Los Angeles, CA, 90089.
2
Department of Epidemiology, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL.
3
Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College, New York, NY.
4
Section of General Internal Medicine, The University of Chicago, Chicago, IL.

Abstract

OBJECTIVE:

To determine whether identification of previously undiagnosed high cholesterol, hypertension, and/or diabetes during an in-home assessment impacts care seeking among Medicare beneficiaries.

DATA SOURCES/STUDY SETTING:

Data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, which recruited African American and white participants across the continental United States from 2003-2007, were linked to Medicare claims.

STUDY DESIGN:

We used panel data models to analyze changes in doctor visits for evaluation and management of conditions after participants were assessed, utilizing the study's rolling recruitment to control for secular trends.

DATA EXTRACTION METHODS:

We extracted Medicare claims for the 24 months before through 24 months after assessment via REGARDS for 5,884 participants.

PRINCIPAL FINDINGS:

Semi-annual doctor visits for previously undiagnosed conditions increased by 22 percentage points (95 percent confidence interval: 16-28) 2 years following assessment. The effect was similar by gender, race, region, and Medicaid, but it may have been lower among participants who lacked a usual health care provider.

CONCLUSIONS:

In-home assessment of cholesterol, blood pressure, and blood glucose can increase doctor visits for individuals with previously undiagnosed conditions. However, biomarker assessment may have more limited impact among individuals with low access to care.

KEYWORDS:

Medicare; diabetes; high cholesterol; hypertension; screening

PMID:
28070913
PMCID:
PMC5980362
DOI:
10.1111/1475-6773.12644

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