Utilization of physician services for diabetic patients from ethnic minorities

被引:20
作者
Shah, Baiju R. [1 ,2 ,3 ,4 ]
机构
[1] Inst Clin Evaluat Sci, Toronto, ON M4N 3M5, Canada
[2] Univ Toronto, Dept Med, Toronto, ON, Canada
[3] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON, Canada
[4] Sunnybrook Hlth Sci Ctr, Toronto, ON M4N 3M5, Canada
基金
加拿大健康研究院;
关键词
diabetes; ethnicity; health services;
D O I
10.1093/pubmed/fdn042
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Diabetes is a common chronic disease, which results in significant morbidity and mortality. Although ethnic variations in disease prevalence are known, variations in the utilization of physician services for the disease (particularly in publicly funded health care systems) are uncertain. Methods Self-reported ethnicity was determined from two population health surveys in Ontario, Canada. These data were linked to administrative data sources, including an administrative data-derived disease registry. Diabetes prevalence was determined for each ethnic group. Utilization of physician services for primary care, diabetes specialist care and eye examinations was compared among ethnic groups, adjusting for age, sex, socioeconomic status and diabetes duration. Results There were 20 788 eligible survey respondents. Standardized diabetes prevalence was elevated for the South Asian and Black populations (11.1 and 11.0%, respectively) compared with that for the White population (5.9%). Ethnic minorities with diabetes were less likely to receive an eye examination compared with White patients (adjusted OR, 0.63; 95% CI, 0.46-0.85). The use of primary care and diabetes specialist care did not differ. Conclusion Ethnic minorities with diabetes are less likely to receive eye examinations. This disparity in quality of care could lead to worse clinical outcomes for these patients.
引用
收藏
页码:327 / 331
页数:5
相关论文
共 40 条
[1]   Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE) [J].
Anand, SS ;
Yusuf, S ;
Vuksan, V ;
Devanesen, S ;
Teo, KK ;
Montague, PA ;
Kelemen, L ;
Yi, CL ;
Lonn, E ;
Gerstein, H ;
Hegele, RA ;
McQueen, M .
LANCET, 2000, 356 (9226) :279-284
[2]  
[Anonymous], CAN COMM HLTH SURV C
[3]   Measuring underuse of necessary care among elderly Medicare beneficiaries using inpatient and outpatient claims [J].
Asch, SM ;
Sloss, EEM ;
Hogan, C ;
Brook, RH ;
Kravitz, RL .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2000, 284 (18) :2325-2333
[4]   Improving primary care for patients with chronic illness [J].
Bodenheimer, T ;
Wagner, EH ;
Grumbach, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (14) :1775-1779
[5]   Diabetes in the African-American Medicare population: Morbidity, quality of care, and resource utilization [J].
Chin, MH ;
Zhang, JX ;
Merrell, K .
DIABETES CARE, 1998, 21 (07) :1090-1095
[6]   Prevalence of diabetes and impaired fasting glucose in adults in the US population - National Health and Nutrition Examination Survey 1999-2002 [J].
Cowie, Catherine C. ;
Engelgau, Michael M. ;
Rust, Keith F. ;
Saydah, Sharon H. ;
Byrd-Holt, Danita D. ;
Williams, Desmond E. ;
Eberhardt, Mark S. ;
Geiss, Linda S. ;
Flegal, Katherine M. ;
Gregg, Edward W. .
DIABETES CARE, 2006, 29 (06) :1263-1268
[7]   The economic cost of diabetes in Canada, 1998 [J].
Dawson, KG ;
Gomes, D ;
Gerstein, H ;
Blanchard, JF ;
Kahler, KH .
DIABETES CARE, 2002, 25 (08) :1303-1307
[8]   Quality of care and outcomes in type 2 diabetic patients [J].
De Berardis, G ;
Pellegrini, F ;
Franciosi, M ;
Belfiglio, M ;
Di Nardo, B ;
Greenfield, S ;
Kaplan, SH ;
Rossi, MCE ;
Sacco, M ;
Tognoni, G ;
Valentini, M ;
Nicolucci, A .
DIABETES CARE, 2004, 27 (02) :398-406
[9]  
Fay MP, 1997, STAT MED, V16, P791
[10]   Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes [J].
Gaede, P ;
Vedel, P ;
Larsen, N ;
Jensen, GVH ;
Parving, H ;
Pedersen, O .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (05) :383-393