Access to Care

Women With Diabetes: Quality of Health Care, 2004-2005

Women with diabetes need a consistent source of health care, either a person or a place, to receive ongoing patient-centered-care, which can delay or prevent the complications of diabetes. Several factors can impede a woman's ability to obtain access to care. Race and ethnicity, SEP, age, and other factors contribute to the lack of ongoing care for women.4 

Usual Source of Care

Women reporting a usual source of care, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women reporting a usual source of care. By diagnosed diabetes status: Women with diagnosed diabetes, 96%; women without diabetes, 82%; all women, 83%. By gender: Women with diagnosed diabetes: Total, 96%; Ages 18-44, 89%; Ages 45-66, 96%; Age 65 and over, 98%. Men with diagnosed diabetes: Total, 95%; Ages 18-44, not given; Ages 45-66, 95%; Age 65 and over, 98%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 1a and 1b.

  • Women with diagnosed diabetes were significantly more likely than women without diabetes to report a usual source of care.
  • No significant difference in having a usual source of care was found between women and men with diagnosed diabetes, either for the total population or for any age groups.

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Usual Primary Care Provider

Women reporting a usual primary care provider, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women reporting a usual primary care provider. By diagnosed diabetes status: Women with diagnosed diabetes, 92%; women without diabetes, 78%; all women, 79%. By gender: Women with diagnosed diabetes: Total, 92%; Ages 18-44, 83%; Ages 45-66, 92%; Age 65 and over, 95%. Men with diagnosed diabetes: Total, 93%; Ages 18-44, not given; Ages 45-66, 93%; Age 65 and over, 96%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 2a and 2b.

  • Women with diagnosed diabetes were significantly more likely than women without diabetes to report that they had a usual primary care provider.
  • No significant difference in having a usual primary care provider was found between women and men with diagnosed diabetes, either overall or within any age group.

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Insurance

Health insurance coverage is an essential component of access to care. Both men and women have many of the same concerns obtaining and utilizing health insurance, but some of these features are unique to women. Affordability and employment qualifications, such as full-time employment, are barriers that women face more often than men in obtaining health insurance.31 These features influence the type, adequacy, and continuity of insurance coverage.

Women ages 18-64 with any type of insurance coverage during the year, by diagnosed diabetes status (left) and gender (right)

Bar charts show percentage of women ages 18-64 with any type of insurance coverage during the year. By diagnosed diabetes status: Women with diagnosed diabetes, 89%; women without diabetes, 86%; all women, 84%. By gender: Women with diagnosed diabetes: Total, 89%; Ages 18-44, 83%; Ages 45-64, 90%. Men with diagnosed diabetes: Total, 91%; Ages 18-44, not given; Ages 45-64, 94%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 3a and 3b.

  • No significant difference in having any type of insurance was found between women with and without diagnosed diabetes.
  • No significant difference in having any type of insurance was found between women and men with diagnosed diabetes, either overall or within any age group.

Women ages 18-64 with private insurance during the year, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women ages 18-64 with private insurance during the year. By diagnosed diabetes status: Women with diagnosed diabetes, 62%; women without diabetes, 71%; all women, 74%. By gender: Women with diagnosed diabetes: Total, 62%; Ages 18-44, 60%; Ages 45-64, 63%. Men with diagnosed diabetes: Total, 78%; Ages 18-44, not given; Ages 45-64, 81%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 4a and 4b.

  • Women under age 65 with diagnosed diabetes were significantly less likely than women without diabetes to have private insurance.
  • For the total population and for those ages 45-64, women with diagnosed diabetes were significantly less likely than men with diagnosed diabetes to have private insurance.

Women ages 18-64 with public insurance (no private insurance) during the year, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women ages 18-64 with public insurance (no private insurance) during the year. By diagnosed diabetes status: Women with diagnosed diabetes, 27%; women without diabetes, 10%; all women, 11%. By gender: Women with diagnosed diabetes: Total, 27%; Ages 18-44, 24%; Ages 45-64, 28%. Men with diagnosed diabetes: Total, 13%; Ages 18-44, not given; Ages 45-64, 13%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 5a and 5b.

  • Women under age 65 with diagnosed diabetes were significantly more likely than women without diabetes to have only public insurance.
  • For the total population and for those ages 45-64, women with diagnosed diabetes were significantly less likely than men with diagnosed diabetes to have private insurance.

Women ages 18-64 with any period of public insurance during the year, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women ages 18-64 with any  period of public insurance during the year. By diagnosed diabetes status: Women with diagnosed diabetes, 33%; women without diabetes, 11%; all women, 14%. By gender: Women with diagnosed diabetes: Total, 33%; Ages 18-44, 30%; Ages 45-64, 32%. Men with diagnosed diabetes: Total, 18%; Ages 18-44, not given; Ages 45-64, 18%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 6a and 6b.

  • Women with diagnosed diabetes were significantly more likely than women without diabetes to have any period of public insurance.
  • For the total population and for people ages 45-64, women with diagnosed diabetes were significantly more likely than men with diagnosed diabetes to have any period of public insurance.

Women ages 18-64 who were uninsured all year, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women ages 18-64 who were uninsured all year. By diagnosed diabetes status: Women with diagnosed diabetes, 12%; women without diabetes, 14%; all women, 14%. By gender: Women with diagnosed diabetes: Total, 12%; Ages 18-44, 170%; Ages 45-64, 10%. Men with diagnosed diabetes: Total, 9%; Ages 18-44, not given; Ages 45-64, 6%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 7a and 7b.

  • No significant difference was found between women with and without diagnosed diabetes who were uninsured all year.
  • Overall and for people ages 45-64, no significant difference was found between women and men with diagnosed diabetes who were uninsured all year.

Women ages 18-64 without insurance for any period during the year, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women ages 18-64 without any insurance for any period during the year. By diagnosed diabetes status: Women with diagnosed diabetes, 20%; women without diabetes, 26%; all women, 26%. By gender: Women with diagnosed diabetes: Total, 20%; Ages 18-44, 30%; Ages 45-64, 17%. Men with diagnosed diabetes: Total, 18%; Ages 18-44, not given; Ages 45-64, 14%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 8a and 8b.

  • No significant difference was found between women with diagnosed diabetes and women without diabetes who had any period without insurance during the year.
  • Overall and for people ages 45-64, no significant difference was found between women and men with diagnosed diabetes who had a period without insurance.

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Emergency Room Visits

In 2007, diabetes cost the United States approximately $174 billion in direct (medical) and indirect (lost productivity) expenditures.32 Of the $116 billion in direct medical expenditures during this same year, $3.3 million was attributable to emergency room encounters.32 Emergency room visits are an indication of the lack of continuity of care for some patients with diabetes. These are people who do not receive the recommended preventive care that is likely to delay or prevent the onset of complications from diabetes. There is no evidence on the extent to which women use emergency rooms or the cost associated with the use of emergency care among women.

Women who reported an emergency room visit in the past year, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women who reported an emergency room visit in the past year. By diagnosed diabetes status: Women with diagnosed diabetes, 24%; women without diabetes, 15%; all women, 16%. By gender: Women with diagnosed diabetes: Total, 24%; Ages 18-44, 23%; Ages 45-66, 26%; Age 65 and over, 22%. Men with diagnosed diabetes: Total, 22%; Ages 18-44, not given; Ages 45-66, 17%; Age 65 and over, 26%.

* Estimate for men ages 18-44 did not meet sample size criteria.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 9a and 9b.

  • Women with diagnosed diabetes were significantly more likely than women without diabetes to have reported an emergency room visit in the past year.
  • Women ages 45-64 with diagnosed diabetes were significantly more likely than men ages 45-64 with diagnosed diabetes to report an emergency room visit in the past year. No significant difference was found between women and men age 65 and over with diagnosed diabetes.

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Transportation

In general, the data on transportation are sparse. However, studies have found that transportation issues can influence whether an individual uses the health care system. Studies conducted in a rural community found that travel burden (arranging transportation, time required to travel, arranging child care, cost of transportation) was an obstacle for people with a chronic condition who were treated at an urban hospital.33-35 The extent to which transportation acts as a barrier to health care among women with and without diagnosed diabetes is unknown.

Women who usually use public transportation to get to a health care provider, by diagnosed diabetes status (left) and gender (right), 2004

Bar charts show percentage of women who usually use public transportation to get to a health care provider. By diagnosed diabetes status: Women with diagnosed diabetes, 5.8%; women without diabetes, 3.4%; all women, 3.7%. By gender: Women with diagnosed diabetes: Total, 5.8%; Ages 18-44, not given; Ages 45-66, 5.5%; Age 65 and over, 6.2%. Men with diagnosed diabetes: Total, 3.4%; Ages 18-44, not given; Ages 45-66, 3.3%; Age 65 and over, not given.

* Estimates were not possible for adults with diabetes ages 18-44, for women with diagnosed diabetes ages 18-44, or for men with diagnosed diabetes ages 18-44 or age 65 and over.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 10a and 10b.

  • Women with diagnosed diabetes were not significantly more likely than women without diabetes to usually use public transportation to get to a provider.
  • For people ages 45-64, no significant difference was found between women and men with diagnosed diabetes who usually used public transportation to get to a provider.
Current as of November 2008
Internet Citation: Access to Care: Women With Diabetes: Quality of Health Care, 2004-2005. November 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/women-and-diabetes-2004-2005/wmdiab4.html