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dc.contributor.advisorRobin E. Clark, Ph.D.
dc.contributor.authorLeung, Yat (Gary) Hung
dc.date2022-08-11T08:08:42.000
dc.date.accessioned2022-08-23T16:04:58Z
dc.date.available2022-08-23T16:04:58Z
dc.date.issued2010-03-02
dc.date.submitted2010-04-02
dc.identifier.doi10.13028/r00y-aw61
dc.identifier.urihttp://hdl.handle.net/20.500.14038/31786
dc.description.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.
dc.language.isoen_US
dc.rightsCopyright is held by the author, with all rights reserved.
dc.subjectMental Disorders
dc.subjectDiabetes Mellitus
dc.subjectComorbidity
dc.subjectQuality of Health Care
dc.subjectMassachusetts
dc.subjectMedicare
dc.subjectMedicaid
dc.subjectEndocrine System Diseases
dc.subjectEndocrinology, Diabetes, and Metabolism
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectInsurance
dc.subjectMental Disorders
dc.subjectNutritional and Metabolic Diseases
dc.subjectPsychiatry and Psychology
dc.titleBehavioral Health Disorders and the Quality of Diabetes Care: A Dissertation
dc.typeDoctoral Dissertation
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1457&context=gsbs_diss&unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/gsbs_diss/456
dc.legacy.embargo2011-03-18T00:00:00-07:00
dc.identifier.contextkey1259471
refterms.dateFOA2022-08-24T04:00:47Z
html.description.abstract<p>Both 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.</p> <p>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).</p> <p>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.</p>
dc.identifier.submissionpathgsbs_diss/456
dc.contributor.departmentFamily Medicine and Community Health
dc.description.thesisprogramClinical and Population Health Research


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