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Observational Study
. 2018 Feb;5(1):7-14.
doi: 10.1007/s40615-016-0335-8. Epub 2017 Jan 11.

Racial/Ethnic Disparities in Diabetes Quality of Care: the Role of Healthcare Access and Socioeconomic Status

Juan R Canedo  1 , Stephania T Miller  2 , David Schlundt  3 , Mary K Fadden  4 , Maureen Sanderson  4
Affiliations
Observational Study

Racial/Ethnic Disparities in Diabetes Quality of Care: the Role of Healthcare Access and Socioeconomic Status

Juan R Canedo et al. J Racial Ethn Health Disparities. 2018 Feb.

Abstract

Introduction: Blacks, Hispanics, and Asians are disproportionately affected by diabetes. We assessed the state of racial/ethnic disparities in diabetes quality of care in the USA.

Methods: We analyzed cross-sectional data of adults diagnosed with Type 2 diabetes in the nationally representative 2013 Medical Expenditure Panel Survey. Differences in adherence to five diabetes quality of care recommendations (HbA1c twice yearly, yearly foot exam, dilated eye exam, blood cholesterol test, and flu vaccination) were examined by race/ethnicity while controlling for three social determinants of health (health insurance status, poverty, and education) and other demographic variables.

Results: Among adults with diabetes in the USA, 74.9% received two or more HbA1c tests, 69.0% had a foot exam, 64.9% had an eye exam, 85.4% had a cholesterol test, and 65.1% received flu vaccination in 2013. Compared to Whites, all were lower for Hispanics; HbA1c tests, eye exam, and flu vaccination were lower for Blacks; HbA1c tests, foot exam, and eye exam were lower for Asians. In adjusted models, the only remaining disparities in quality of care indicators were HbA1c tests for Hispanics (AOR 0.67, CI = 0.47-0.97), Blacks (AOR 0.59, CI = 0.40-0.88), and Asians (AOR 0.47, CI = 0.42-0.99); foot exams for Hispanics (AOR 0.65, CI = 0.47-0.90); and flu vaccination for Blacks (AOR 0.68, CI = 0.49-0.93).

Conclusion: Lack of insurance coverage and education explained some of the racial/ethnic disparities observed in diabetes quality of care. Improving quality of diabetes care could help reduce rates of diabetes complications, healthcare costs, and mortality.

Keywords: Diabetes; Disparities; Quality of care.

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References

    1. Center for Disease Control and Prevention . National Diabetes Statistics Report: Estimates of Diabetes and its Burden in the United States, 2014 [Internet] U.S. Department of Health and Human Services; GA: 2014. pp. 1–12. Available from: https://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report....
    1. Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol. Rev. 2013;93:137–88. - PubMed
    1. Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Johansen K, et al. US Renal Data System 2011 Annual Data Report. Am. J. Kidney Dis. 2012;59:A7. - PubMed
    1. Zhang X, Saaddine JB, Chou C-F, Cotch MF, Cheng YJ, Geiss LS, et al. Prevalence of Diabetic Retinopathy in the United States, 2005–2008. JAMA J. Am. Med. Assoc. 2010;304:649–56. - PMC - PubMed
    1. Chow EA, Foster H, Gonzalez V, McIver L. The Disparate Impact of Diabetes on Racial/Ethnic Minority Populations. Clin. Diabetes. 2012;30:130–3.

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