Coberley Carter R, Puckrein Gary A, Dobbs Angela C, McGinnis Matthew A, Coberley Sadie S, Shurney Dexter W
Healthways, Inc., Nashville, Tennessee 37215, USA.
Dis Manag. 2007 Jun;10(3):147-55. doi: 10.1089/dis.2007.641.
In addition to race and ethnicity, specific geographic regions are associated with poorer outcomes of care. Individuals with diabetes experiencing health disparities typically have worse long-term outcomes, such as increased diabetes complications and mortality. Zip code mapping, or geocoding, was utilized in this study to identify regions of the United States with high diabetes prevalence rates and to identify areas with high densities of minority populations. Use of this methodology to examine the effect of disease management on a large, diverse diabetes population revealed greater improvement in clinical testing rates in health disparity zones compared with members living outside of these areas. In particular, significant improvement was achieved by members living in minority zip codes and by members aged 65 years or older. These findings demonstrate that members living in areas of health disparity obtain even greater benefit from diabetes disease management program participation, helping to reduce gaps in care.
除了种族和民族外，特定地理区域与较差的护理结果相关。经历健康差异的糖尿病患者通常有更差的长期结果，如糖尿病并发症增加和死亡率上升。本研究利用邮政编码映射或地理编码来识别美国糖尿病患病率高的地区以及少数族裔人口密度高的地区。使用这种方法来检查疾病管理对大量不同糖尿病患者群体的影响，结果显示，与居住在这些地区以外的成员相比，健康差异地区的临床检测率有更大改善。特别是，居住在少数族裔邮政编码地区的成员以及65岁及以上的成员取得了显著改善。这些发现表明，居住在健康差异地区的成员从参与糖尿病疾病管理项目中获得了更大的益处，有助于缩小护理差距。
