The National Institutes of Health funded this study and the findings were published online in the Journal of the American Board of Family Medicine.
Ms. Rachel Gold, lead author and investigator with the Kaiser Permanente Center for Health Research in Portland, Oregon, said that their study showed that patients need continuous health insurance coverage so as to ensure adequate preventive care, even when that care is provided at a reduced cost.
Most of the services at the safety net clinics are free, but some of the diagnostic tests require a small co-pay that is covered by Medicaid. Patients who lose their Medicaid coverage often delay getting the tests because they can't afford the co-pay.
3,384 diabetic patients were covered under the study who received medical care from 2005-2007 at 50 federally qualified health centers in Oregon. Regardless of their insurance status, low-income patients were provided free or reduced-cost by these health centers. During the 3 year study period, about 52% of the patients had continuous coverage provided by Medicaid, 27% had no insurance, and 21% had interrupted coverage,. Patients with private insurance were excluded from the study.
48% of patients with continuous insurance coverage received at least 3 lipid-screening tests at one of the study clinics over the 3 year study period; 25% received 3 or more flu shots; 72% received 3 or more screenings for blood glucose; and 19% received 3 or more screenings for kidney damage. Patients with no coverage, and patients with interruptions in coverage, received significantly fewer of these services than patients with continuous health insurance coverage.
The study showed that as insurance coverage increased there was no increase in services received. All patients with interruptions in health - insurance coverage were equally vulnerable to missing services, compared to the continuously insured. These findings suggest that public insurance coverage must be continuous to ensure that patients receive consistent and timely care.