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Predictors of Undiagnosed Diabetes among Middle-Aged and Seniors in China: Application of Andersen’s Behavioral Model

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Listed:
  • Chaozhou Mou

    (Department of Mathematics Statistics, Shandong University, Weihai 264209, China)

  • Minlan Xu

    (Department of Social Work, Shandong University, Weihai 264209, China)

  • Juncheng Lyu

    (Department of Public Health, Weifang Medical University, Weifang 261000, China)

Abstract

Undiagnosed diabetes is a threat to public health. This study aims to identify potential variables related to undiagnosed diabetes using Andersen’s behavioral model. Baseline data including blood test data from the China Health and Retirement Longitudinal Study (CHARLS) were adopted. First, we constructed health service related variables based on Andersen model. Second, univariate analysis and multiple logistic regression were used to analyze the relations of variables to undiagnosed diabetes. The strength of relationships was presented by odds ratios (ORs) and 95% confidence intervals (CIs). Finally, the prediction of multiple logistic regression model was assessed using the Receiver Operating Characteristic (ROC) curve and the area under the ROC curve (AUC). According to diagnosis standards, 1234 respondents had diabetes, among which 560 were undiagnosed and 674 were previously diagnosed. Further analysis showed that the following variables were significantly associated with undiagnosed diabetes: age as the predisposing factor; medical insurance, residential places and geographical regions as enabling factors; having other chronic diseases and self-perceived health status as need factors. Moreover, the prediction of regression model was assessed well in the form of ROC and AUC. Andersen model provided a theoretical framework for detecting variables of health service utilization, which may not only explain the undiagnosed reasons but also provide clues for policy-makers to balance health services among diverse social groups in China.

Suggested Citation

  • Chaozhou Mou & Minlan Xu & Juncheng Lyu, 2021. "Predictors of Undiagnosed Diabetes among Middle-Aged and Seniors in China: Application of Andersen’s Behavioral Model," IJERPH, MDPI, vol. 18(16), pages 1-9, August.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8396-:d:610682
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    References listed on IDEAS

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    4. Sean Mahoney & Adam Bradley & Logan Pitts & Stephanie Waletzko & Sheria G. Robinson-Lane & Timothy Fairchild & Donna J. Terbizan & Ryan McGrath, 2020. "Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults," IJERPH, MDPI, vol. 17(13), pages 1-15, June.
    5. Susan P Fisher-Hoch & Kristina P Vatcheva & Mohammad H Rahbar & Joseph B McCormick, 2015. "Undiagnosed Diabetes and Pre-Diabetes in Health Disparities," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-10, July.
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