Table 5.
Underserved Medicare Beneficiaries with Diabetes: Comparison of Urban and Nonurban Groups (standard errors in parentheseso)
| Underserved Trial Sample (2000–2002) | UrbanpUnderserved Trial Sample (2000–2002) | Nonurban Underserved Trial Sample (2000–2002) | t-statistic or Chi-square (P value) for urban/nonurban comparison | |
|---|---|---|---|---|
| Self-Care | ||||
| Measures blood glucose | 92.9% (0.8%) | 91.1% (1.1%) | 94.4% (1.1%) | F = 4.19 (P = 0.04) |
| Frequency of measuring blood glucose (among) | F = 5.56 (P = 0.0042) | |||
| 20.3% | 24.3% | 17.0% | ||
| <once a day | 47.9 | 46.0 | 49.6 | |
| once a day | 31.8 | 29.7 | 33.5 | |
| >once a day | ||||
| Pills for blood glucose | 82.0% (1.0%) | 83.9% (1.5%) | 80.4% (1.4%) | F = 2.75 (P = 0.03) |
| Takes insulin | 29.9% (1.2%) | 30.5% (1.8%) | 29.4% (1.7%) | F = 0.19 (P = 0.66) |
| Frequency (per day) of taking insulin (among) | 1.87 (0.03) | 1.78 (0.04) | 1.94 (0.04) | t-stat = 2.87 (P = 0.004) |
| Syringe insulin administration (among) | 91.9% (1.3%) | 97.2% (1.2%) | 87.2% (2.1%) | F = 14.8 (P = 0.0002) |
| Disposable pen insulin administration (among) | 8.2% (1.8%) | 4.3% (1.4%) | 11.6% (1.2%) | F = 8.5 (P = 0.004) |
| Cartridge pen Insulin administration (among) | 4.2% (1.1%) | 1.4% (.8%) | 6.6% (1.8%) | F = 7.0 (P = 0.009) |
| Pump insulin administration (among) | 1.1% (.5%) | 0 (NA or 0%) | 2.1% (.9%) | F = 4.8 (P = 0.03) |
| Regular insulin (among) | 49.5% (2.5%) | 45.5% (3.7%) | 52.9% (3.5%) | F = 2.16 (P = 0.14) |
| Lispro (Humalog) (among) | 9.1% (1.4%) | 5.2% (1.6%) | 12.6% (2.1%) | F = 7.2 (P = 0.008) |
| NPH (Among) | 16.2% (1.7%) | 16.5% (2.6%) | 15.9% (2.2%) | F = 0.032 (P = 0.86) |
| Glargine (Lantus) (among) | 4.2% (1.0%) | 2.4% (1.1%) | 5.9% (1.7%) | F = 3.5 (P = 0.064) |
| Pre-mixed insulin (among) | 41.6% (2.9%) | 31.7% (3.7%) | 50.5% (3.9%) | F = 11.7 (P = 0.0007) |
| Patient Self-Care Burden | ||||
| Minutes/day caring for diabetes | 28.3 (1.1) | 35.7 (1.6) | 22.1 (1.1) | t-stat = 6.99 (P < 0.001) |
| Any Internet time for diabetes | 4.3% (.5%) | 2.3% (0.6%) | 6.1% (08%) | F = 13.36 (P = 0.0003) |
| Minutes/week on Internet for diabetes | 4.4 (1.1) | 2.4 (1.2) | 6.2 (1.7) | t-stat = 1.83 (P = 0.067) |
| Minutes/week on reading for diabetes | 30.8 (2.2) | 27.9 (3.9) | 33.3 (2.5) | t-stat = 1.16 (P = 0.245) |
| Waiting time per visit (minutes)q | 41.4 (2.3) | 64.1 (2.7) | 21.3 (1.3) | t-stat = 14.6 (P < 0.001) |
| Round trip traveling time (minutes) per visit | 47.2 (1.2) | 49.7 (1.7) | 45.1 (1.7) | t-stat = 1.9 (P = 0.058) |
| Out-of-pocket costs for diabetes supplies (monthly) | $4.29 (0.49) | $3.57 (0.59) | $4.92 (0.74) | t-stat = 1.42 (P = 0.156) |
| Family contributes to diabetes supplies | 1.1% (0.3%) | 1.7% (0.5%) | 0.6% (0.3%) | F = 4.2 (P = 0.04) |
| General Health Behaviors | ||||
| Days of week with good diet | 5.0 (0.8) | 4.6 (1.2) | 5.4 (1.0) | t-stat = 5.2 (P < 0.001) |
| Days of week physical activity | 3.6 (0.1) | 2.2 (0.1) | 4.7 (0.1) | t-stat = 14.9 (P < 0.001) |
| Days of week exercise | 2.6 (0.1) | 2.9 (0.1) | 2.3 (0.1) | t-stat = 4.3 (P < 0.001) |
| Smoking at all in last week | 8.8% (0.8%) | 8.1% (1.1%) | 9.5% (1.0%) | F = 0.86 (P = 0.35) |
| Number of cigarettes smoked (among smokers) | 13.5 (1.1) | 10.8 (1.5) | 15.5 (1.5) | t-stat = 2.3 (P = 0.026) |
| Formal Health Care Utilization | ||||
| Any test-only visit | 35.6% | 36.2% | 35.1% | F = 0.14 (P = 0.70) |
| Any doctor's visit | 90.5% (0.8%) | 92.1% (1.1%) | 89.1% (1.1%) | F = 3.39 (P = 0.066) |
| Any ER visit | 13.0% (0.9%) | 16.5% (1.4%) | 10.0% (1.1%) | F = 13.7 (P = 0.0002) |
| Any hospital admission | 8.5% (0.8%) | 10.5% (1.2%) | 6.9% (0.9%) | F = 5.94 (P = 0.015) |
| Any physical therapy | 8.2% (0.7%) | 9.5% (1.1%) | 7.0% (0.9%) | F = 3.13 (P = 0.077) |
| Any visiting nurse | 12.5% (1.1%) | 21.2% (1.6%) | 5.1% (0.8%) | F = 81.4 (P < 0.0001) |
| Any adult day care | 0.7% (0.2%) | 0.7% (0.3%) | 0.7% (0.3%) | F = 0.002 (P = 0.96) |
| Any home health aide | 5.7% (.6%) | 7.8% (1.0%) | 3.9% (.7%) | F = 9.5 (P = 0.002) |
| Any home personal care | 7.8% (.9%) | 15.5% (1.4%) | 1.2% (.4%) | F = 115.6 (P < 0.0001) |
| Any case management | 14.8% (1.0%) | 10.7% (1.1%) | 18.4% (1.6%) | F = 16.2 (P = 0.0001) |
| Any home meal delivery | 4.8% (0.6%) | 2.2% (0.6%) | 7.1% (1.0%) | F = 18.2 (P < 0.0001) |
| Any transportation services | 9.4% (1.0%) | 17.4% (1.5%) | 2.5% (0.5%) | F = 101.24 (P < 0.0001) |
| Any telephone check | 2.1% (0.4%) | 1.6% (0.5%) | 2.6% (0.6%) | F = 1.85 (P = 0.174) |
| Any nutritionist | 4.1% (0.5%) | 4.8% (0.8%) | 3.6% (0.7%) | F = 1.36 (P = 0.24) |
| Any diabetes educator | 3.1% (0.5%) | 2.9% (0.6%) | 3.3% (0.8%) | F = 0.19 (P = 0.66) |
| Any substance abuse rehab care | 0.3% (0.1%) | 0.14% (0.1%) | 0.37% (0.2%) | F = 0.71 (P = 0.40) |
| Any psychiatric or psychological services | 4.5% (0.6%) | 6.6% (1.0%) | 2.6% (0.5%) | F = 14.4 (P = 0.0002) |
| Any phone contact with doctor | 9% (1%) | 10% (1%) | 8% (1%) | t stat = 1.38 (P = 0.167) |
| Any phone contacts with other provider | 12.0% (1.0%) | 7.7% (1%) | 15.7% (1.5%) | t stat = 4.49 (P < 0.001) |
| Any e-mail with doctor | 0.3% (0.1%) | 0.6% (0.3%) | 0.1% (0.1%) | t stat = 1.45 (P = 0.147) |
| Any e-mail with other provider | 1.5% (0.4%) | 1.5% (0.5%) | 1.5% (0.5%) | t stat = 0.04 (P = 0.969) |
| Assistance | ||||
| Hours/week help from family | 8.32 (0.46) | 5.18 (0.42) | 11.0 (0.59) | t stat = 8.04 (P < 0.001) |
| Hours/week help from friends | 0.56 (0.08) | 0.40 (0.10) | 0.69 (0.13) | t stat = 1.75 (P = 0.08) |
| Hours/week family take off to help | 0.05 (0.01) | 0.03 (0.01) | 0.06 (0.02) | t stat = 1.11 (P = 0.27) |
| Hours/week paid help | 3.70 (0.42) | 7.22 (0.68) | 0.72 (0.12) | t stat = 9.5 (P < 0.001) |
| Hours/week help with housework | 5.94 (0.32) | 4.44 (0.31) | 7.14 (0.44) | t stat = 4.98 (P < 0.001) |
| Hours/week help with meal prep | 4.64 (0.22) | 4.02 (0.28) | 5.15 (0.31) | t stat = 2.67 (P = 0.008) |
| Hours/week help with personal care | 0.51 (0.06) | 0.65 (0.08) | 0.40 (0.09) | t stat = 2.14 (P = 0.03) |
| Hours/week help with anything else | 1.67 (0.10) | 1.40 (0.11) | 1.87 (0.16) | t stat = 2.41 (P = 0.016) |
o
Standard errors for the underserved sample are corrected for physician-level clustering. Standard errors for the MEPS data are corrected for complex survey sampling.
p
The majority of the urban sample is of Latino descent while the majority of the nonurban sample is white and non-Latino.
q
This is the mean time for the first visit. Subsequent visits are not statistically different.