Hu Ruwei, Shi Leiyu, Liang Hailun, Haile Geraldine Pierre, Lee De-Chih
Department of Health Management, School of Public Health, Sun Yat-sen University, China, and Johns Hopkins Primary Care Policy Center, Baltimore, Maryland.
Johns Hopkins Primary Care Policy Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Prev Chronic Dis. 2016 Aug 4;13:E100. doi: 10.5888/pcd13.160113.
Racial and ethnic disparities exist in diabetes prevalence, access to diabetes care, diabetes-related complications and mortality rates, and the quality of diabetes care among Americans. We explored racial and ethnic disparities in primary care quality among Americans with type 2 diabetes.
We analyzed data on adults with type 2 diabetes derived from the household component of the 2012 Medical Expenditure Panel Survey. Multiple regression and multivariate logistic regressions were used to examine the association between race/ethnicity and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, and clusters of confounding factors were added sequentially.
Preliminary findings indicated differences in primary care quality between racial/ethnic minorities and whites across measures of first contact, longitudinality, comprehensiveness, and coordination. After controlling for confounding factors, these differences were no longer apparent; all racial/ethnic categories showed similar rates of primary care quality according to the 4 primary care domains of interest in the study.
Results indicate equitable primary care quality for type 2 diabetes patients across 4 key domains of primary care after controlling for socioeconomic characteristics. Additional research is necessary to support these findings, particularly when considering smaller racial/ethnic groups and investigating outcomes related to diabetes.
在美国,糖尿病患病率、获得糖尿病护理的机会、糖尿病相关并发症及死亡率,以及糖尿病护理质量方面存在种族和民族差异。我们探讨了美国2型糖尿病患者在初级保健质量方面的种族和民族差异。
我们分析了来自2012年医疗支出小组调查家庭部分的2型糖尿病成年患者数据。使用多元回归和多变量逻辑回归来检验种族/民族与与首次接触、连续性、全面性和协调性相关的初级保健属性之间的关联,并依次添加混杂因素集群。
初步结果表明,在首次接触、连续性、全面性和协调性指标方面,少数种族/民族与白人在初级保健质量上存在差异。在控制混杂因素后,这些差异不再明显;根据研究中关注的4个初级保健领域,所有种族/民族类别显示出相似的初级保健质量率。
结果表明,在控制社会经济特征后,2型糖尿病患者在初级保健的4个关键领域获得了公平的初级保健质量。需要进一步的研究来支持这些发现,特别是在考虑较小的种族/民族群体并调查与糖尿病相关的结果时。