Date Approved

4-25-2023

Graduate Degree Type

Project

Degree Name

Public Health (M.P.H.)

Degree Program

Public Health

First Advisor

Sarah Nechuta

Academic Year

2022/2023

Abstract

Background: Epilepsy is one of the most common neurological diseases worldwide; diabetes is a chronic metabolic disease that affects how the body produces and uses insulin. Prescribed medications are vital for controlling these and other chronic diseases by minimizing severe health issues, which can be affected by insurance type and status. Consequences of non-adherence include uncontrolled blood glucose in people with diabetes and uncontrolled seizures in people with epilepsy. We aimed to compare the healthcare resource utilization and medication adherence of people with epilepsy and people with diabetes by insurance status. Methods: Data was from the 2021 National Health Interview Survey. The sample (n=3,645) focused on adults 18 and older who self-reported having epilepsy (n=511) or diabetes (n=3,134). Covariates included sex, age, education level, and race. Descriptive and logistic regression analyses were weighted to account for the complex survey design. Results: When compared with public insurance and after adjusting for covariates, uninsured people with epilepsy had 5.96 times (95% CI 1.71-20.75) the odds and uninsured people with diabetes had 5.33 times (95% CI 3.11-9.12) the odds of delaying care. The uninsured with epilepsy had 9.63 (95% CI 2.24-41.43) times the odds, and those with diabetes had 3.82 (95% CI 2.16-6.73) times the odds of taking less medication. Conclusions: In line with previous research, being uninsured is a barrier to adherence and to healthcare utilization. Uninsured people with epilepsy and people with diabetes had higher odds of non-adherence with prescriptions; they also had higher odds of inconsistent healthcare resource utilization.

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