Faculty Advisor

Dr. Kathleen Baker



Presentation Date


Document Type



In the U.S, diabetes has become one of the major health concerns. In like manner, health insurance coverage is vital to the health needs of individuals. Adults having elevated glucose levels are recommended to receive glycated hemoglobin (HbA1c) testing to determine the average blood sugar concentrations. Differences in insurance coverage has significant impact on recommended screenings.

The study analyzes secondary data from 2011 to 2013 for three different health plans being Medicaid, Blue Care Network (BCN) and Blue Cross Blue Shield (BCBS) of Michigan. Statistical methods were used to ascertain the best regression model for count data and the association between county specific health and socioeconomic factors and insurance plans associated with the HbA1c testing.

The study finds the negative binomial model is best in predicting count health data. Also, urban-rural interface and type of insurance plan are key in understanding patterns and frequency of diabetes service utilization. The BCBS plan has more people taking the required HBA1C test compared to the BCN and Medicaid. Across all plans, analysis indicate that interventions should be focused on the southern part of Michigan. Further, health and socioeconomic factors determine the rate and frequency of the HbA1c screening.

Included in

Geography Commons