ArticleBMC health services research2016
Quality of diabetes care and health insurance coverage: a retrospective study in an outpatient academic public hospital in Switzerland.
Article in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Article
- Epidemiology of hypertension among patients with type 2 diabetes in the Democratic Republic of Congo.African journal of primary health care & family medicine · 2025Article
- Blacklisting Health Insurance Premium Defaulters: Is Denial of Medical Care Ethically Justifiable?Health care analysis : HCA : journal of health philosophy and policy · 2023Article
- Perspectives for glycaemic control in type 2 diabetes in Kinshasa, Democratic Republic of the Congo.Health promotion international · 2023Article
- Poor glycaemic control: prevalence, factors and implications for the care of patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo: a cross-sectional study.Frontiers in clinical diabetes and healthcare · 2023Article
- Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis.Diabetology & metabolic syndrome · 2022Article
- 'Managing scarcity'- a qualitative study on volunteer-based healthcare for chronically ill, uninsured migrants in Berlin, Germany.BMJ open · 2019Article
- Article
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3 authors.
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Abstract
backgroundSocioeconomic disadvantage is associated with an increased risk of adverse diabetes outcomes. In Switzerland, a country with theoretical universal healthcare coverage, people without health insurance face barriers in accessing to and in receiving standard quality care. The Geneva University Hospitals (HUG) have implemented policies aiming at reducing these gaps. We compared quality of diabetes care and ambulatory healthcare services utilization among insured and uninsured diabetic patients.
methodsThis retrospective study linked health and administrative data of type 2 diabetic outpatients with at least one HbA1c test performed in 2012-2013 at HUG. Quality of care evaluation relied on processes (annual serum HbA1c, cholesterol and microalbuminuria tesing) and outcomes (HbA1c) assessment. Healthcare utilization was assessed by the number of ambulatory clinical and laboratory visits. Results were stratified by disease course (newly diagnosed versus prevalent diabetes).
resultsOf the 198 patients included, 80 (40.4 %) were uninsured. Both groups underwent annual testing of HbA1c, cholesterol, kidney function and microalbuminuria at comparably high rates and numbers of ambulatory visits did not significantly differ. After adjustments for age and sex, there were no significant differences in serum HbA1c between groups both in those with prevalent or with newly diagnosed diabetes. Initial medical intervention entailed comparable glycaemic improvement after 6 months in incident diabetes among insured and uninsured patients.
conclusionsThis study did not find any difference in quality of diabetes care between insured and uninsured patients in a public hospital enforcing health-equity policies for access to and for delivery of standard diabetes care. It highlights the frontline role of public hospitals in contributing to care delivery equity even in countries with theoretical universal healthcare coverage.
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