Abstract
Objective. To determine whether enhanced primary care services delivered preferentially to high- risk patients with diabetes (HbA1c >9%) can effectively reduce racial/ethnic disparities in glycemic control. Methods. This retrospective study analyzed electronic health records to examine changes in pre- vs. post- intervention disparities in HbA1c among Hispanics/Latinos relative to non- Hispanic Whites. Results. Mean HbA1c and prevalence of poorly controlled diabetes improved in both racial/ethnic groups, but to a greater extent among Hispanics/Latinos. Mean HbA1c dropped 0.43 points further among Hispanics/Latinos than non- Hispanic Whites (95% CI, –0.57 to –0.29, p<.001). The change in disparity in prevalence of poorly controlled diabetes, measured as the ratio of post- vs. pre- intervention prevalence ratios, was 0.89 (95% CI, 0.84 to 0.94, p<.001). Both measures indicated greater reduction among Hispanics/Latinos relative to non- Hispanic Whites. Discussion. Enhanced primary care services directed at high- risk patients may improve glycemic control and reduce racial/ethnic disparities in diabetes- related outcomes in medically underserved communities.
Original language | English |
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Pages (from-to) | 676-686 |
Number of pages | 11 |
Journal | Journal of Health Care for the Poor and Underserved |
Volume | 29 |
Issue number | 2 |
DOIs | |
State | Published - May 2018 |
Keywords
- Diabetes mellitus
- Health disparities
- Latino Americans
- Minority health care
- Primary care