Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Pearson-Clarke T [original query] |
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Changes over time in high out-of-pocket health-care burden in U.S. adults with diabetes, 2001-2011
Li R , Baker LE , Shrestha S , Zhang P , Duru OK , Pearson-Clarke T , Gregg EW . Diabetes Care 2014 37 (6) 1629-35 OBJECTIVE: High out-of-pocket (OOP) costs can be an obstacle to health-care access and treatment compliance. This study investigated trends in high OOP health-care burden in people with diabetes. RESEARCH DESIGN AND METHODS: Using Medical Expenditure Panel Survey 2001-2011 data, we examined trends in the proportion of people aged 18-64 years with diabetes facing a high OOP burden. We also examined whether the trend differed by insurance status (private insurance, public insurance, or no insurance) or by income level (poor and near poor, low income, middle income, or high income). RESULTS: In 2011, 23% of people with diabetes faced high OOP burden. Between 2001-2002 and 2011, the proportion of people facing high OOP burden fell by 5 percentage points (P < 0.01). The proportion of those who were publicly insured decreased by 22 percentage points (P < 0.001) and of those who were uninsured by 12 percentage points (P = 0.01). Among people with diabetes who were poor and near poor and those with low income, the proportion facing high OOP burden decreased by 21 (P < 0.001) and 13 (P = 0.01) percentage points, respectively; no significant change occurred in the proportion with private insurance or middle and high incomes between 2001-2002 and 2011. CONCLUSIONS: The past decade has seen a narrowing of insurance coverage and income-related disparities in high OOP burden in people with diabetes, yet almost one-fourth of all people with diabetes still face a high OOP burden. |
A nationwide community-based lifestyle program could delay or prevent type 2 diabetes cases and save $5.7 billion in 25 years
Zhuo X , Zhang P , Gregg EW , Barker L , Hoerger TJ , Pearson-Clarke T , Albright A . Health Aff (Millwood) 2012 31 (1) 50-60 The increasing health and economic burden of diabetes has made preventing the disease a public health priority. But investing in such chronic disease prevention programs requires a long-term horizon because many years may be required for the downstream savings to fully offset the up-front intervention cost. Using a simulation model, we projected the costs and benefits of a nationwide community-based lifestyle intervention program for preventing type 2 diabetes. Accounting for all costs to the US health care system, our results indicate that the program would break even in fourteen years. Within twenty-five years, the program would prevent or delay about 885,000 cases of type 2 diabetes in the United States and produce savings of $5.7 billion nationwide. If restricted to people ages 65-84, the program would save $2.4 billion. Thus, implementing such a program nationwide would be an efficient use of health care resources, although it might be necessary for all health insurers to participate to share prevention costs. Our results also indicate that although a prevention program would lead to cost savings in both younger and older people, it would achieve greater health and economic gains if it were directed at people under age sixty-five. |
Recommendations for worksite-based interventions to improve workers' health
Task Force on Community Preventive Services , Pearson-Clarke T . Am J Prev Med 2010 38 S232-6 Over the past 25 years, the number of organizations and companies offering a health promotion program for their employees at the worksite has increased dramatically; by 1990, 81% of worksites and by 2000, nearly 90% of all workplaces with at least 50 employees offered their employees some type of health promotion program.1, 2 There are several reasons why health promotion in U.S. work settings has become increasingly common. The top five health conditions (heart disease, cancers, cerebrovascular disease, chronic lower respiratory disease, and unintentional injuries) are responsive to intervention; American adults spend increasing hours at work; and poor employee health results in substantial financial and productivity costs to employers. | In comparison to nonworksite environments, the worksite provides a number of advantages for health promotion: (1) the potential for intervention exposure because of a large and rather stable population; (2) the potential for adequate or enhanced promotion of, recruitment for, and participation in programs; and (3) the potential for social support networks and peer influences among coworkers as reinforcement of efforts.3 |
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