title: Racial and ethnic disparities in the quality of diabetes care in a nationally representative sample.
abstract: BACKGROUND
  Previous studies have consistently documented that racial/ethnic minority patients with diabetes receive lower quality of care, based on various measures of quality of care and care settings. However, 2 recent studies that used data from Medicare or Veterans Administration beneficiaries have shown improvements in racial/ethnic disparities in the quality of diabetes care. These inconsistencies suggest that additional investigation is needed to provide new information about the relationship between racial/ethnic minority patients and the quality of diabetes care.
  
  
  METHODS
  We analyzed 3 years of data (2005-2007) from the Medical Expenditure Panel Survey and used multivariate models that adjusted for sociodemographic characteristics, regional location, insurance status, health behaviors, health status, and comorbidity to examine racial/ethnic disparities in the quality of diabetes care.
  
  
  RESULTS
  We found that Asian patients with diabetes were less likely to have received 2 or more glycated hemoglobin (HbA1c) tests or a foot examination during the past year compared with their white counterparts. Hispanic patients with diabetes were also less likely to have received a foot examination during the past year compared with white patients with diabetes. Conversely, black patients with diabetes were more likely to have received a foot examination during the past year compared with white patients with diabetes. The differences in the quality of diabetes care remained significant even after controlling for socioeconomic status (SES), health insurance status, self-rated health status, comorbid conditions, and lifestyle behavior variables.
  
  
  CONCLUSIONS
  Although the link between racial/ethnic minority status and the quality of care for patients with diabetes is not completely understood, our results suggest that factors such as SES, health insurance status, self-rated health status, and other health conditions are potential antecedents of quality of diabetes care.
authors: Department of Health Policy, The George Washington University School of Public Health and Health Services, 2021 K St, NW Ste 800, Washington, DC 20006, USA. patrick.richard@gwumc.edu
authors: Patrick
authors: P
authors: Richard
authors: Pierre Kébreau
authors: PK
authors: Alexandre
authors: Anthony
authors: A
authors: Lara
authors: Adaeze B
authors: AB
authors: Akamigbo
mesh_terms: D003920:Diabetes Mellitus / Q000208:ethnology* / Q000628:therapy; D019468:Disease Management; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology