Frequency and predictors of missed visits to primary care and eye care providers for annually recommended diabetes preventive care services over a two-year period among U.S. adults with diabetes

This paper examines the patterns of visits to primary care and eye care providers for annually recommended diabetes preventive care services over a two-year period in a sample of U.S. adults aged 18 years and older with diabetes drawn from the 2008-2013 Medical Expenditure Panel Survey-Household Component (n = 3982). The four-category outcome variable was defined based on the four possible combinations of whether an individual missed an annual visit to a primary care provider for preventive care services in at least one year over the two-year period and whether the individual missed an annual visit to an eye care provider in at least one year over this period. Descriptive statistics and a multinomial logistic regression model were estimated. 51.9% of the sample missed an annual visit to a primary care or eye care provider for preventive care services over a two-year period. Although 48.8% of the sample missed at least one annual visit to an eye care provider, 85.6% of these individuals did visit a primary care provider for preventive care services during the year they did not visit an eye care provider. This suggests that primary care-based screening for diabetic retinopathy could reach most individuals who do not receive regular eye care. Regression results particularly relevant for potential interventions were that missing annual visits was significantly more likely for individuals without health insurance or a usual source of healthcare and for those who were not receiving diabetes treatments and did not have or were not aware of having diabetes-related complications.