Healthcare Access and Diabetes Diagnosis Assignment

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Assignment Task

Statement of the Problem

This project aimed to examine the effect of diabetes on adults 18 years of age and older living in rural to low-income communities. There is a need to understand diabetes and delay in diagnosis as it pertains to rural areas in Georgia. Challenges with rural health are highlighted as a barrier and contributing factor to the delay in diagnosis and its effect on health. The goal was to answer proposed research questions and test the hypotheses through quantitative study methods. The issue poses questions such as: Why is there a delay in disease diagnosis? Why do mortality rates continue to increase? Why do low-income and rural communities suffer more than those that are not? How can individuals in these communities extend their quality of life and provide better access to more resources? How does health visits impact health outcome? Does health coverage affect hospital visits, medication management, and treatment options? How does healthcare cost burden individuals and affect health outcomes?

Many research projects have worked to answer these questions and create interventions to reduce the impact on risk groups and communities. This quantitative study aimed to examine the delay of diagnosis corresponding with health visits affecting diabetes access care in rural, low-income communities on adults 18 years of age and older who are or are not medically insured.

Nature of the Study

To address the research questions in this quantitative study, the specific research design includes the cross-sectional method for the study, being new samples of people are being utilized each time with the possibility of information simultaneously changing. Longitudinal would not have been the best method because it tracks the same individuals over time. Providing resources and tools to such communities assisted in decreasing diabetes and increasing education and awareness. The method best assisted in answering the research question by researching evidence that it exists. It also revealed how to fix the problem and answer the research question with evidence and a resolution.

The nature of the study addressed the gap in health coverage and hospital visits for chronic illness patients that fall into the rural low-income categories. Using delay of access to delay of diagnosis is a significant issue with diabetes, so it is safe to assume a person who has not accessed healthcare for some time is delayed in diagnosis. Haw et al. (2021) used a similar cross-sectional method to analyze the epidemiological patterns in complications from diabetes, particularly in minorities, as well as healthcare utilization and prevention. The reference supports the idea of highlighting the different factors that plague the adverse outcomes of the groups being studied.

This was a study with secondary data analysis using a dependent variable as the delay of diagnosis. For my completed research design, I used databases such as 2017 Behavioral Risk Factor Surveillance System (BRFSS) in finding secondary data for the study itself. The Behavioral Risk Factor Surveillance System is a dataset that is readily available and accessible for public health. This dataset contains numerous variables which can be used to create a cross-sectional study. The data points examined are the number of individuals affected by diabetes that are living in rural low-income neighborhoods that either are or are not insured and have had health visits.

To report the number of individuals affected, patients self-reported their challenges in seeking needed medical care. The main question was, “Was there a time in the past 12 months when you needed to see a doctor but could not because of cost?” For further information, the reason may be explored but not included in the regression model. Other variables included information on age, gender, and ethnicity, which are present within the 2019 BRFSS dataset. The variable for doctor attendance in correspondence with delay in diagnosis of diabetes is useful because the onset of diabetes happens at least 4-7 years prior to diagnosis (Harris et al., 1992).

Based on this information, it was proposed that a delay in medical care is the cause of a delay in diabetes diagnosis.

Research Questions

To analyze the association between the dependent and independent variables, the proposed research questions are mentioned below. With these questions, we looked to fill the previously mentioned gap in literature and highlight the social impact between diabetes and at-risk individuals and groups. 

Question 1

Is there an association between delay in diagnosis of type 2 diabetes and health insurance coverage in low-income and rural communities after controlling for age, gender, and ethnicity?

Dependent Variable:  Delay of Diagnosis, General Health, Routine Checkup, # of days physical health poor, been told you have prediabetes/diabetes, Time seen health professional for diabetes

Independent Variables: Health Insurance Coverage, Age, Gender, and Income Level, and Education Level

Ho1: There is no statistical significance between health insurance coverage, age, gender, and ethnicity impacting the delay in diagnosis of diabetes in low-income rural communities.

Ha1: There is a statistical significance between health insurance coverage, age, gender, and ethnicity impacting the delay in diagnosis of diabetes in low-income rural communities.

Question 2

Is there an association between delay of diagnosis of type 2 diabetes and lack of access to healthcare resources (defined by number of visits) in low-income and rural communities after controlling for age, gender, and ethnicity?

Dependent Variable:  Delay of Diagnosis, General Health, Routine Checkup, # of days physical health poor, been told you have prediabetes/diabetes, Time seen health professional for diabetes

Independent Variables: Health Insurance Coverage, Age, Gender, and Income Level, and Education Level

Ho2: There is no statistical significance between health resources defined by number of visits, age, gender, and ethnicity impacting the delay in diagnosis of diabetes in low-income rural communities.

Ha2: There is a statistical significance between health resources defined by number of visits, age, gender, and ethnicity impacting the delay in diagnosis of diabetes in low-income rural communities.

Table 1 describes the intent for each variable. Each variable has a summarized description as its intent to the future data that will be presented further into the report. Each label in the left column represents the dependent and independent variables being introduced into the study.

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