Racial comparisons of diabetes care and intermediate outcomes in a patient-centered medical home
Open accessAbstract
OBJECTIVE To assess racial differences in diabetes processes and intermediate outcomes of care in an internal medicine, patient-centered medical home (PCMH) group practice. RESEARCH DESIGN AND METHODS We conducted a retrospective cohort study of 1,457 adults with diabetes receiving care from 89 medical providers within a PCMH-designated academic practice between 1 July 2009 and 31 July 2010. We used mixed models to assess independent associations between patient race (non-Hispanic white or black) and 1) receipt of processes of care (A1C and LDL testing, foot and retinal examination, and influenza and pneumococcal vaccination) and 2) achievement of intermediate outcomes (LDL <100 mg/dL, blood pressure [BP] <140/90 mmHg, A1C <7.0% [<53 mmol/mol], and A1C >9.0% [>75 mmol/mol]), controlling for sociodemographic factors, health status, treatment intensity, and clinical continuity. RESULTS Compared with non-Hispanic white patients, black patients were younger, were more often single, had lower educational attainment, and were less likely to have commercial insurance. In unadjusted analyses, fewer black patients received a retinal examination and influenza vaccination during the study period or any lifetime pneumococcal vaccination (P < 0.05 [all comparisons]). Fewer black patients achieved an LDL <100 mg/dL, BP <140/90 mmHg, or A1C <7.0% (<53 mmol/mol), while more black patients had an A1C >9.0% (>75 mmol/mol) (P < 0.05 [all comparisons]). In multivariable models, black patients were less likely to receive A1C testing (odds ratio [OR] 0.57 [95% CI 0.34-0.95]) or influenza vaccination (OR 0.75 [95% CI 0.57-0.99]) or to achieve an LDL <100 mg/dL (OR 0.74 [95% CI 0.55-0.99]) or BP <140/90 mmHg (OR 0.64 [95% CI 0.49-0.84]). CONCLUSIONS Racial differences in processes and intermediate outcomes of diabetes care were present within this PCMH-designated practice, controlling for differences in sociodemographic, clinical, and treatment factors.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In a retrospective cohort study of 1,457 diabetic patients receiving care in a PCMH academic practice, African-American patients were less likely to receive HbA1c testing than non-Hispanic Caucasians, after adjusting for multiple demographic factors and comorbidities.
“In fact, in a retrospective cohort study of 1,457 diabetic patients receiving care in a PCMH academic practice, African-American patients were less likely to receive HbA 1c testing or influenza vaccination or to meet LDL or blood pressure targets than non-Hispanic Caucasians, after adjusting for multiple demographic factors and comorbidities (102).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [102]
In the same retrospective cohort study, African-American patients were less likely to receive influenza vaccination than non-Hispanic Caucasians, after adjusting for multiple demographic factors and comorbidities.
“In fact, in a retrospective cohort study of 1,457 diabetic patients receiving care in a PCMH academic practice, African-American patients were less likely to receive HbA 1c testing or influenza vaccination or to meet LDL or blood pressure targets than non-Hispanic Caucasians, after adjusting for multiple demographic factors and comorbidities (102).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [102]
In the same retrospective cohort study, African-American patients were less likely to meet LDL targets than non-Hispanic Caucasians, after adjusting for multiple demographic factors and comorbidities.
“In fact, in a retrospective cohort study of 1,457 diabetic patients receiving care in a PCMH academic practice, African-American patients were less likely to receive HbA 1c testing or influenza vaccination or to meet LDL or blood pressure targets than non-Hispanic Caucasians, after adjusting for multiple demographic factors and comorbidities (102).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [102]
In the same retrospective cohort study, African-American patients were less likely to meet blood pressure targets than non-Hispanic Caucasians, after adjusting for multiple demographic factors and comorbidities.
“In fact, in a retrospective cohort study of 1,457 diabetic patients receiving care in a PCMH academic practice, African-American patients were less likely to receive HbA 1c testing or influenza vaccination or to meet LDL or blood pressure targets than non-Hispanic Caucasians, after adjusting for multiple demographic factors and comorbidities (102).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [102]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 46 · Cited by 19
- Authors
- Simonetti, J. A., Fine, M. J., Chen, Y.-F., Simak, D., & Hess, R.
- Affiliations
- University of Washington (US)
- University of Pittsburgh (US)
- University of Illinois Chicago (US)
- Corresponding author
- Simonetti, Joseph A.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2014-03-08
- Volume
- 37
- Issue
- 4
- Pages
- 993-1001
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3964485
- OpenAlex
- W2099471726
- Cited by
- 19
- References
- 46
- Citations by year
- 2023: 3 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 3
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (UL1TR000005, UL1-TR- 000005, UL1-TR-)
- National Center for Research Resources (UL1RR024153)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- racial disparities, patient-centered medical home, intermediate outcomes, A1C testing, LDL cholesterol control, blood pressure control, influenza vaccination, pneumococcal vaccination, retinal examination, foot examination, Black patients, quality of care, sociodemographic factors, health insurance status, educational attainment, glycemic control, lipid control
- MeSH terms
- Adult, Aged, Continuity of Patient Care, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Patient-Centered Care, Black People, White People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
