Joseph Jennifer M, Johnson Pamela Jo, Wholey Douglas R, Frederick Mary L
School of Public Health, Division of Health Policy & Management, University of Minnesota, 420 Delaware St. SE, MMC 729, Minneapolis, MN, 55455.
Division of Applied Research, Allina Health, Minneapolis, MN.
Health Serv Res. 2015 Aug;50(4):1250-64. doi: 10.1111/1475-6773.12277. Epub 2014 Dec 18.
To identify and describe racial/ethnic disparities in overall diabetes management.
DATA SOURCE/STUDY SETTING: Electronic health record data from calendar year 2010 were obtained from all primary care clinics at one large health system in Minnesota (n = 22,633).
We used multivariate logistic regression to estimate the odds of achieving the following diabetes management goals: A1C <8 percent, LDL cholesterol <100 mg/dl, blood pressure <140/90 mmHg, tobacco-free, and daily aspirin.
Blacks and American Indians have higher odds of not achieving all goals compared to whites. Disparities in specific goals were also found.
Although this health system has above-average diabetes care quality, significant disparities by race/ethnicity were identified. This underscores the importance of stratifying quality measures to improve care and outcomes for all.
识别并描述总体糖尿病管理中的种族/族裔差异。
数据来源/研究背景:2010日历年的电子健康记录数据来自明尼苏达州一个大型医疗系统的所有初级保健诊所(n = 22,633)。
我们使用多变量逻辑回归来估计实现以下糖尿病管理目标的几率:糖化血红蛋白(A1C)<8%、低密度脂蛋白胆固醇<100毫克/分升、血压<140/90毫米汞柱、戒烟和每日服用阿司匹林。
与白人相比,黑人和美国印第安人未实现所有目标的几率更高。在特定目标方面也发现了差异。
尽管该医疗系统的糖尿病护理质量高于平均水平,但仍发现了显著的种族/族裔差异。这凸显了对质量指标进行分层以改善所有人的护理和治疗结果的重要性。