How high-deductible health plans (HDHPs), which reduce overall spending but may impede care by increasing out-of-pocket expenses, are associated with risks of severe hypoglycemia and hyperglycemia is unknown. Importance Optimal diabetes care requires regular monitoring and care to maintain glycemic control. Meaning In this study, patients with diabetes who switched to HDHPs were significantly more likely to experience serious, but preventable, acute diabetes complications compared with patients who remained in conventional insurance plans these findings suggest the need for policy solutions to address health plan-mediated barriers to diabetes care. Although forced transition to HDHP did not increase the odds of ED and/or hospital visits for severe hypoglycemia over the whole observation period, the odds increased by 2% for each year enrolled in an HDHP. Question Does an employer-mandated switch to a high-deductible health plan (HDHP) increase the risks of severe hypoglycemia and hyperglycemia among patients with diabetes?įindings In this cohort study of 245 055 US adults with diabetes enrolled in employer-sponsored health plans, forced transition to an HDHP increased the odds of experiencing an emergency department (ED) or hospital visit for severe hyperglycemia by 25% during the study period, with the odds increasing 5% for each year of HDHP enrollment.
The killing also has raised questions about whether France has failed to move on since it was wracked by weeks of urban rioting in 2005. The fatal police shooting of a 17-year-old outside Paris this week has set off widespread disorder in French suburbs, with protesters burning cars, garbage and buildings.
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