Factors Associated with Reducing Diabetes-Related Disparities of Rural Latinos We propose a research study that would greatly expand the opportunity for students to be involved in research, contribute to their knowledge about the healthcare service needs of rural populations, and stimulate research at our university about healthcare for minority ethnic/racial rural populations, especially rural Latinos. The proposed study addresses the problem of health disparities among rural populations as a whole, and among rural Latino residents specifically. The U.S. Latino population is growing at a rapid pace. As a group, they are at a high risk for developing diabetes. Compared to other groups, they have high percentages of overweight or obesity, which are among the risk factors associated with Type 2 diabetes (Centers for Disease Control and Prevention, 2014). The complications of diabetes are serious and costly to the patient and the healthcare system as a whole. To date, little is known about the potential impact of Accountable Care Organizations (ACOs) on ethnic/racial disparities in healthcare (Pollack & Armstrong, 2011). Knowing how ACOs affect these disparities is particularly essential because some minority groups, such as Latinos, African Americans, and Native Americans, are more concentrated in rural areas (Institute of Medicine, 2005). We propose a longitudinal study, the purpose of which is to: 1) compare health disparities and patient outcomes of rural Latino older adult patients diagnosed with diabetes to their non-Latino White counterparts, and 2) ascertain the impact of ACO participation by rural primary care providers (along with other factors) on rural Latino older adult patients. The study has two goals:
Aim 1 : To measure the disparities in diabetes-related hospitalization rates between rural Latino older adult patients of Medicare ACOs and rural non-Latino White older adult patients, and Aim 2: To identify factors related to reduced disparities in diabetes-related hospitalization rates of rural Latino older adult patients, including RHC participation in a Medicare ACO. We will apply a pre-post design treating Medicare ACO participation as an intervention. The project will use data for a four-year period before the Medicare ACOs began (2008 - 2011) and a four-year period afterwards (2012 - 2015). The project will proceed in 3 major phases as follows: 1) collecting, merging, and organizing secondary data from multiple sources; 2) researching and constructing variables to include in the analyses; and 3) conducting univariate, bivariate, and multivariate analyses. The study will contribute to rural health research by adding to the knowledge about: 1) the factors that contribute to minimizing diabetes-related health disparities of rural Latino adults, 2) the diabetes preventive care effectiveness of ACOs, and 3) the types of ACOs most beneficial to rural Latino patients.
The proposed study addresses the problem of health disparities among rural populations as a whole, and among rural Latino residents specifically. Using a pre-post design that treats Medicare ACO participation as an intervention, we will measure the disparities in diabetes-related hospitalization rates between rural Latino older adult patients and rural non-Latino White older adult patients, and identify factors related to reduced disparities in diabetes-related hospitalization rates of rural Latino older adult patients, including Rural Health Clinic participation in a Medicare ACO.
