1237-P: Factors Associated with Health-Care Avoidance among Medicare Beneficiaries Aged 65 Years and Over with Reported Type 2 Diabetes

Abstract

Healthcare avoidance by Medicare beneficiaries (MBs) with type 2 diabetes (T2D) can result in significant health and financial burdens. Timely detection/treatment of T2D-related complications can mitigate these burdens. There is limited research using the Anderson Model of Healthcare Utilization to examine healthcare avoidance among MBs with T2D. Therefore, we examined factors associated with healthcare avoidance among MBs with reported T2D. We analyzed two healthcare avoidance measures (“do anything to avoid going to the doctor (DATAGTTD)” and “try to keep sickness to themselves (TTKSTT)”) using the nationally representative 2015 Medicare Current Beneficiary Survey (n=12,311) from CMS. MBs were stratified into two groups, those with and without T2D. We performed four survey-weighted logit models, with two healthcare avoidance variables on those with and without T2D, adjusting for covariates. Approximately 22.4% of MBs reported having T2D. Among those with and without T2D, 28.5% and 26.1% respectively reported they would DATAGTTD. Also, 37.8% of MBs with T2D and 39% of MBs without T2D reported they would TTKSTT. Two key factors were positively associated (P<.01) with DATAGTTD for both groups: 1) worrying about health more than others, 2) past experiences with doctors missing health issues. Also, reporting past experiences with doctors missing health issues was a key factor positively associated (P<.01) with TTKSTT for both groups. Other factors such as socio-economic status, physical limitations, depression, and cost were associated (P<.05) with TTKSTT and DATAGTTD. However, factors differed between those with and without T2D. Although over 90% of MBs with T2D have a regular doctor, one-third of them reported TTKSTT and one-fourth of them reported DATAGTTD. There is a need to address and improve doctor-patient communication for MBs with T2D to avoid unnecessary and costly healthcare avoidance for this particular at-risk group. Disclosure B. Ng: None. B.C. Peach: None. C. Park: None. S.D. Towne: None. J.B. LaManna: None.