title: Assessing Diabetes Care Disparities with Ambulatory Care Quality Measures.
abstract: OBJECTIVE
  To identify and describe racial/ethnic disparities in overall diabetes management.
  
  
  METHODS
  Electronic health record data from calendar year 2010 were obtained from all primary care clinics at one large health system in Minnesota (n = 22,633).
  
  
  METHODS
  We used multivariate logistic regression to estimate the odds of achieving the following diabetes management goals: A1C <8 percent, LDL cholesterol <100 mg/dl, blood pressure <140/90 mmHg, tobacco-free, and daily aspirin.
  
  
  RESULTS
  Blacks and American Indians have higher odds of not achieving all goals compared to whites. Disparities in specific goals were also found.
  
  
  CONCLUSIONS
  Although this health system has above-average diabetes care quality, significant disparities by race/ethnicity were identified. This underscores the importance of stratifying quality measures to improve care and outcomes for all.
authors.affiliation: School of Public Health, Division of Health Policy & Management, University of Minnesota, 420 Delaware St. SE, MMC 729, Minneapolis, MN, 55455.|Division of Applied Research, Allina Health, Minneapolis, MN.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Joseph
authors.affiliation: Center for Spirituality and Healing, University of Minnesota, Minneapolis, MN.|Medica Research Institute, Minneapolis, MN.
authors.forename: Pamela Jo
authors.initials: PJ
authors.lastname: Johnson
authors.affiliation: Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Wholey
authors.affiliation: Allina Health Clinics, Diabetes Education, Minneapolis, MN.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Frederick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001241:Aspirin / Q000008:administration & dosage; D008078:Cholesterol, LDL / Q000097:blood; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000628:therapy*; D057286:Electronic Health Records; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D011787:Quality of Health Care; D044469:Racial Groups / Q000706:statistics & numerical data*; D016540:Smoking Cessation; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D001241:Aspirin; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin
keywords: Diabetes; cardiovascular risk factors; composite quality measures; minority health; racial/ethnic disparities