Behavioral Health Disorders and the Quality of Diabetes Care: A Dissertation
AuthorsLeung, Yat (Gary) Hung
Faculty AdvisorRobin E. Clark, Ph.D.
Academic ProgramClinical and Population Health Research
UMass Chan AffiliationsFamily Medicine and Community Health
Document TypeDoctoral Dissertation
Quality of Health Care
Endocrine System Diseases
Endocrinology, Diabetes, and Metabolism
Health Services Administration
Health Services Research
Nutritional and Metabolic Diseases
Psychiatry and Psychology
MetadataShow full item record
AbstractBoth diabetes and behavioral health disorders (mental and substance use disorders) are significant health issues in the United States. While previous studies have shown worse health outcomes in people with diabetes and co-occurring behavioral health disorders (BHDs) than those with diabetes alone, it is unclear whether the quality of diabetes care was poorer in the presence of co-occurring BHDs. Although previous research has observed a trend of positive outcomes in people with comprehensive diabetes care, there is a lack of evidence about whether that mode of care delivery can improve outcomes in people with co-occurring BHDs. Therefore, further studies are necessary. Using a combined dataset from Medicare and Medicaid claims for Massachusetts residents, this study compared the quality of diabetes care (e.g., having at least 1 hemoglobin A1c test) and diabetes outcomes (e.g., eye complications) among Medicare and Medicaid beneficiaries with diabetes and co-occurring BHDs to those with diabetes alone in Massachusetts in 2005. The results showed a mixed picture on the relationships between BHDs and diabetes outcomes. While substance use disorders had adverse impact on adherence to quality measures (e.g., 20% less likely to attain full adherence, p0.05). Findings from this dissertation research suggest that disparities exist in the quality of diabetes care and health outcomes between people with substance use disorders and those without. The mode of care delivery needs to be further examined so that interventions can be designed to improve the outcomes of people with diabetes.
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/31786
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