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Observational Study
. 2020 Mar 16;20(1):216.
doi: 10.1186/s12913-020-05095-8.

Is insurance instability associated with hypertension outcomes and does this vary by race/ethnicity?

Nancy R Kressin  1 , Norma Terrin  2 , Amresh D Hanchate  3 , Lori Lyn Price  2 , Alejandro Moreno-Koehler  2 , Amy LeClair  4 , Jillian Suzukida  5 , Sucharita Kher  6 , Karen M Freund  7
Affiliations
Observational Study

Is insurance instability associated with hypertension outcomes and does this vary by race/ethnicity?

Nancy R Kressin et al. BMC Health Serv Res. .

Abstract

Background: Stable health insurance is often associated with better chronic disease care and outcomes. Racial/ethnic health disparities in outcomes are prevalent and may be associated with insurance instability, particularly in the context of health insurance reform.

Methods: We examined whether insurance instability was associated with uncontrolled blood pressure (UBP) and whether this association varied by race/ethnicity. We used a retrospective longitudinal observational cohort study of patients diagnosed with hypertension who obtained care within two health systems in Massachusetts. We measured the UBP, insurance instability, and race of 43,785 adult primary care patients, age 21-64 with visits from 1/2005-12/2013.

Results: We found higher rates of UBP for blacks and Hispanics at each time point over the entire 9 years. Insurance instability was associated with greater rates of UBP. Always uninsured black patients fared worst, while white and Hispanic patients with consistent public insurance fared best.

Conclusions: Stable insurance of any type was associated with better hypertension control than no or unstable insurance.

Keywords: Health; Health status disparity; Hypertension; Insurance.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Insurance instability by race/ethnicity
Fig. 2
Fig. 2
UBP by race and time
See this image and copyright information in PMC

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