Utilization of physician services for diabetic patients from ethnic minorities.
BACKGROUND
Diabetes is a common chronic disease, which results in significant morbidity and mortality. Although ethnic variations in disease prevalence are known, variations in the utilization of physician services for the disease (particularly in publicly funded health care systems) are uncertain.


METHODS
Self-reported ethnicity was determined from two population health surveys in Ontario, Canada. These data were linked to administrative data sources, including an administrative data-derived disease registry. Diabetes prevalence was determined for each ethnic group. Utilization of physician services for primary care, diabetes specialist care and eye examinations was compared among ethnic groups, adjusting for age, sex, socioeconomic status and diabetes duration.


RESULTS
There were 20,788 eligible survey respondents. Standardized diabetes prevalence was elevated for the South Asian and Black populations (11.1 and 11.0%, respectively) compared with that for the White population (5.9%). Ethnic minorities with diabetes were less likely to receive an eye examination compared with White patients (adjusted OR, 0.63; 95% CI, 0.46-0.85). The use of primary care and diabetes specialist care did not differ.


CONCLUSIONS
Ethnic minorities with diabetes are less likely to receive eye examinations. This disparity in quality of care could lead to worse clinical outcomes for these patients.
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada. baiju.shah@ices.on.ca
Baiju R
BR
Shah
D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008913:Minority Groups; D009864:Ontario / Q000453:epidemiology