Health Insurance Coverage, Doctor-Patient Relationship, and Health Care Utilization

A recent study published in Preventive Medicine Reports explored the effect of health insurance coverage and doctor-patient relationships on the likelihood that an individual would receive diagnostic tests for diabetes and cardiovascular disease. Using data collected from 230 participants in the Labor Market Health Care Survey (LMHCS), the study examined three questions:

  • How does health insurance affect the likelihood of having a regular health care provider?
  • How does health insurance coverage affect the likelihood of receiving tests for cardiovascular disease?
  • To what extent does having a regular health care health care provider mediate the effect of health insurance coverage on receiving the diagnostic tests?

The research team, led by Dr. Kenneth Hudson, the LMHCS was a multi-wave longitudinal study of adults 18 and older living in nine high-poverty census tracts in a county of approximately 400,000 residents. For the study, high poverty census tracts were defined as those where 50% of the households have incomes below the poverty threshold. Interview participants were selected through a two-stage random sample. To be included in the study, an individual had to be over 18 years of age. While data collection began in 2006, about 90% of the data in this study were collected since 2013. The research team interviewed participants every 2 to 3 years when they could be located. During interviews, participants provide information on their household composition, employment history, health status, health care utilization and income. Of the 230 participants in the study, about half were under the age of 40.

Analysis of the data included 3 dependent variables:

  • Whether or not participants have health insurance from any source
  • Whether or not the participant has a regular health care provider and knows their doctor’s name
  • Whether or not participants receive diagnostic tests for blood pressure, cholesterol levels and blood sugar levels.

In terms of health insurance coverage, only 12% of participants reported having coverage through an employer, 7% purchased coverage from the private market, and 5% had coverage through a family member. About ⅓ of participants had coverage through Medicare or Medicaid. The final ⅓ did not have any type of insurance coverage.

In relation to health care utilization, 45% of participants reported not having a regular provider. 17% reported having a regular health care provider but did not know their doctor’s name. The remaining 38% had a regular provider and could report the doctor’s name. Around half of the participants reported having cholesterol, blood sugar and blood pressure tests in the last 2 years.

Through the analysis, Dr. Hudson and his team found that participants with health insurance coverage were more likely to have had recent tests for diabetes and cardiovascular disease than those without coverage. However, they also found that having a regular health care provider mediates the effects of insurance coverage, especially when the participant could report the name of their doctor.

Read the full study.

Advertisements