DOI: 10.3886/e182923v2-157288
title: Companion Files for Racial Differences in Patient Experience and Diabetes Management Outcomes among Reproductive-Age Women

description: The STATA do files for creating recodes and analyzing the data files will be provided in this folder for each paper once submitted for publication. Revised do files will be uploaded after the peer review process is complete if there are any changes to the files. <br><br>The data for this study are publicly available on the Medical Expenditure Panel Survey website (https://meps.ahrq.gov/mepsweb/). <br><br><b>Summary</b><br>Significant racial and ethnic disparities in cardiometabolic
diseases, such as diabetes, underline entrenched health inequalities in the
United States. Non-pregnant, non-Hispanic black women of reproductive age
(18-45 years) are more likely to have diagnosed and undiagnosed diabetes, which
increases their risk of maternal morbidity and mortality during the perinatal
period. Adherence to disease management and monitoring during the preconception
period is crucial, especially among non-Hispanic black women who are
disproportionately impacted by maternal morbidity and mortality. Studies have
shown positive patient experiences are associated with adherence to recommended
medication and treatment, preventive care use, and self-rated health outcomes. There
is a dearth of studies, however, examining the effects of patient experiences
(and racial differences in patient experiences) on chronic disease management
outcomes specifically among non-pregnant, reproductive-age women with diabetes.
An understanding of these associations have important implications for maternal
morbidity and mortality. The goal of this study is to use the Medical
Expenditure Panel Survey datasets (2012-2017 longitudinal files) and robust
statistical modeling techniques to investigate racial differences in patient
experience among non-pregnant, reproductive-age women with diabetes and its
relation to ratings of health care received, diabetes care self-efficacy, and
diabetes care monitoring. This study provides important information for
researchers, clinicians, and policy-makers. The research addresses the
Maternal and Child Health Bureau (MCHB) Strategic Research Issue II: MCH
services and systems of care efforts to eliminate health disparities and
barriers to health care access for MCH populations. This study informs the
development of equitable clinical patient-centered practices that promote optimal
disease management among diverse women and reduce racial and ethnic disparities
in maternal health outcomes. It also strengthens and expands MCH Services
Block Grant National Performance and Population Priority Domain I: “Well-Woman
Visits and Preconception/Interconception Health”. This study is expected to
help determine whether positive patient experiences can improve women’s
confidence in their abilities to manage their diabetes, and increase their
likelihood of receiving recommended diabetes care during the preconception or
interconception period. By elucidating the mechanisms by which promoting
patient-centered diabetes care interventions during the preconception/interconception
period might improve disease management, our study can inform practices and
policies that contribute to the attainment of following Healthy People 2020
Maternal, Infant, and Child Health (MIC) Objectives: Increase the proportion of
women delivering a live birth who received preconception care services and
practiced key recommended preconception health behaviors (MICH-16); Reduce the
rate of maternal illness and complications due to pregnancy (MICH-6); and
Reduce the rate of maternal mortality (MICH-5). Furthermore, our study findings
are expected identify the patient experiences that have the greatest impact on
diabetes management outcomes, and can lead to policy changes for provider
reimbursements for demonstrating quality patient-provider interactions. By
providing insights into ways health care professionals can better communicate
with this at-risk population, our study is relevant to the attainment of
Healthy People 2020 Health Communication and Health Information Technology
(HC/HIT) Objectives: Increase the proportion of persons who report that their
health care providers have satisfactory communication skills (HC/HIT-2) and Increase
the proportion of persons who report that their health care providers always
involved them in decisions about their health care as much as they wanted
(HC/HIT-3).