The impact of insurance types on work experience and medical utilization of diabetics

Research objectives: The first objective of this dissertation is to assess the economic burden of diabetes from the perspective of employers as well as how these cost burdens are affected by the nature of the worker's insurance coverage. The second objective is to assess the quality of diabetes care using quality measures by type of health plan. The final objective investigates whether diabetics enrolled in consumer directed health plans are more likely to be hospitalized, or hospitalized at a more severe disease stage, compared with diabetics enrolled in more traditional health insurance plans.;Sources of Data: Truven MarketScan Commercial Claims and Encounters databases for time period 2004 through Q12011, Truven MarketScan Health and Productivity Management database, Truven MarketScan Laboratory Results database, and the Medical Episode Grouper.;Key Results: The employer's direct medical costs for beneficiaries with diabetes were higher than for beneficiaries without diabetes. Inpatient hospital costs account for the majority of the incremental costs.;The employer's indirect costs for beneficiaries with diabetes were higher than for beneficiaries without diabetes.;A lack of statistical significance suggests that the adjusted medical cost for diabetics enrolled in CDHPs is no different than the adjusted medical cost for diabetics enrolled in PPOs. Diabetic men are more likely to retire earlier and diabetic women are likely to retire later than non-diabetic men. Diabetics enrolled in CDHPs are more likely to get the recommended tests and maintain the recommended LDL levels than diabetics with other forms of insurance, but they are also more likely to maintain poor HbA1c levels.;CDHP diabetics are less likely to be admitted to inpatient facilities when compared to PPO diabetics; and when admitted, CDHP diabetics are presented at a comparable disease stage as PPO diabetics.