Quality of care for Hispanic adults with diabetes.
OBJECTIVE
Hispanics in the United States are disproportionately affected by diabetes. We examined the quality of care for Hispanic and non-Hispanic white adults with diabetes to investigate potential disparities in health care.


METHODS
We analyzed the 2004 Behavioral Risk Factor Surveillance System (BRFSS), which included data from 42 states, Puerto Rico, the Virgin Islands, and Guam. Information was collected on 18,510 non-Hispanic whites and 2,078 Hispanics. Established measures of quality care for diabetes included measurement of hemoglobin A1c (HbA1c), foot check by health professional, dilated eye exam, flu and pneumococcal immunizations, diabetes education, and self-monitoring of feet and blood glucose.


RESULTS
Hispanics were less likely than non-Hispanic whites to receive appropriate diabetes quality of care and to self monitor their disease. Ethnic disparities for receipt of HbA1c tests and foot exams persisted even after controlling for access to care, socioeconomic status, and demographics. In Hispanic-only analyses, predictors of not receiving a HbA1c test were having fewer visits to the doctor for diabetes in the past year, having lower income, and Spanish language during the BRFSS interview.


CONCLUSIONS
Disparities in quality of care for diabetes exist between Hispanics and non-Hispanic whites. Multifaceted strategies that incorporate culturally appropriate care and continuity of patient care may help to eliminate these disparities.
Mainous
Arch G
AG
Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. mainouag@musc.edu
Diaz
Vanessa A
VA
Koopman
Richelle J
RJ
Everett
Charles J
CJ
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D040343:Behavioral Risk Factor Surveillance System; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000628:therapy*; D017719:Diabetic Foot / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D012648:Self Care; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D006442:Glycated Hemoglobin