Diabetes Care, Vol 20, Issue 6 971-977, Copyright © 1997 by American Diabetes Association

ARTICLES

Comparison of laboratory test frequency and test results between African-Americans and Caucasians with diabetes: opportunity for improvement. Findings from a large urban health maintenance organization

K Wisdom, JP Fryzek, SL Havstad, RM Anderson, MC Dreiling and BC Tilley
Henry Ford Health System, Henry Ford Health Sciences Center, Center for Medical Treatment Effectiveness Programs, Detroit, MI 48202, USA. kwisdom1@biostat.hfh.edu

OBJECTIVE: To compare African-American and Caucasian patients with preexisting diabetes in a health maintenance organization (HMO) on: 1) frequency with which they received a subset of recommended laboratory tests according to the American Diabetes Association (ADA) consensus guidelines and 2) the results of laboratory test values (glycosylated hemoglobin, cholesterol, and creatinine). RESEARCH DESIGN AND METHODS: A cross-sectional study of 2,312 HMO members with diabetes continuously enrolled during 1991 was conducted using computerized medical record and billing data. Receipt of the ADA recommended tests for glycosylated hemoglobin, cholesterol, and creatinine was compared between African-Americans and Caucasians, stratified by insulin requirements. In addition, group comparisons were made based on the laboratory test results. RESULTS: Less than 20 percent of all subjects received the recommended number of ADA tests. This did not differ by race except for creatinine and cholesterol testing in insulin users only, where African-Americans had more tests. On average, after adjusting for covariates, African-Americans had significantly higher glycosylated hemoglobin and creatinine laboratory values. Both groups had elevated cholesterol values. CONCLUSIONS: The opportunity exists to improve the process of care for both African-Americans and Caucasians with diabetes in an HMO setting. The need to improve glycosylated hemoglobin results and subsequently limit complications is especially pressing among the African-American population.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. M. Gill and Yingxia Chen Quality of Lipid Management in Outpatient Care: A National Study Using Electronic Health Records American Journal of Medical Quality, September 1, 2008; 23(5): 375 - 381. [Abstract] [PDF]

				W. H. Herman, Y. Ma, G. Uwaifo, S. Haffner, S. E. Kahn, E. S. Horton, J. M. Lachin, M. G. Montez, T. Brenneman, E. Barrett-Connor, et al. Differences in A1C by Race and Ethnicity Among Patients With Impaired Glucose Tolerance in the Diabetes Prevention Program Diabetes Care, October 1, 2007; 30(10): 2453 - 2457. [Abstract] [Full Text] [PDF]

				J. K. Kirk, R. B. D'Agostino Jr., R. A. Bell, L. V. Passmore, D. E. Bonds, A. J. Karter, and K.M. V. Narayan Disparities in HbA1c Levels Between African-American and Non-Hispanic White Adults With Diabetes: A meta-analysis. Diabetes Care, September 1, 2006; 29(9): 2130 - 2136. [Abstract] [Full Text] [PDF]

				J. M. Gill, A. J. Foy Jr, and Y. Ling Quality of Outpatient Care for Diabetes Mellitus in a National Electronic Health Record Network American Journal of Medical Quality, January 1, 2006; 21(1): 13 - 17. [Abstract] [PDF]

				A. S. Adams, F. Zhang, C. Mah, R. W. Grant, K. Kleinman, J. B. Meigs, and D. Ross-Degnan Race Differences in Long-Term Diabetes Management in an HMO Diabetes Care, December 1, 2005; 28(12): 2844 - 2849. [Abstract] [Full Text] [PDF]

				L. C. Lanting, I. M.A. Joung, J. P. Mackenbach, S. W.J. Lamberts, and A. H. Bootsma Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients: A review Diabetes Care, September 1, 2005; 28(9): 2280 - 2288. [Abstract] [Full Text] [PDF]

				J. Two Feathers, E. C. Kieffer, G. Palmisano, M. Anderson, B. Sinco, N. Janz, M. Heisler, M. Spencer, R. Guzman, J. Thompson, et al. Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership: Improving Diabetes-Related Outcomes Among African American and Latino Adults Am J Public Health, September 1, 2005; 95(9): 1552 - 1560. [Abstract] [Full Text] [PDF]

				J. K Kirk, R. A Bell, A. G Bertoni, T. A Arcury, S. A Quandt, D. C Goff Jr., and K M V. Narayan Ethnic Disparities: Control of Glycemia, Blood Pressure, and LDL Cholesterol Among US Adults with Type 2 Diabetes Ann. Pharmacother., September 1, 2005; 39(9): 1489 - 1501. [Abstract] [Full Text] [PDF]

				A. Philis-Tsimikas, C. Walker, L. Rivard, G. Talavera, J. O.F. Reimann, M. Salmon, and R. Araujo Improvement in Diabetes Care of Underinsured Patients Enrolled in Project Dulce: A community-based, culturally appropriate, nurse case management and peer education diabetes care model Diabetes Care, January 1, 2004; 27(1): 110 - 115. [Abstract] [Full Text] [PDF]

				A. M. McBean, Z. Huang, B. A. Virnig, N. Lurie, and D. Musgrave Racial Variation in the Control of Diabetes Among Elderly Medicare Managed Care Beneficiaries Diabetes Care, December 1, 2003; 26(12): 3250 - 3256. [Abstract] [Full Text] [PDF]

				J. M. Gill, A. G. Mainous III, J. J. Diamond, and M. J. Lenhard Impact of Provider Continuity on Quality of Care for Persons With Diabetes Mellitus Ann. Fam. Med, September 1, 2003; 1(3): 162 - 170. [Abstract] [Full Text] [PDF]

				M. B. Davidson Effect of Nurse-Directed Diabetes Care in a Minority Population Diabetes Care, August 1, 2003; 26(8): 2281 - 2287. [Abstract] [Full Text] [PDF]

				M. I. Harris Racial and Ethnic Differences in Health Care Access and Health Outcomes for Adults With Type 2 Diabetes Diabetes Care, March 1, 2001; 24(3): 454 - 459. [Abstract] [Full Text]

				P. Sherwood, I. Lyburn, S. Brown, and S. Ryder How are abnormal results for liver function tests dealt with in primary care? Audit of yield and impact BMJ, February 3, 2001; 322(7281): 276 - 278. [Abstract] [Full Text]

				R. E. Glasgow, R. G. Hiss, R. M. Anderson, N. M. Friedman, R. A. Hayward, D. G. Marrero, C. B. Taylor, and F. Vinicor Report of the Health Care Delivery Work Group: Behavioral research related to the establishment of a chronic disease model for diabetes care Diabetes Care, January 1, 2001; 24(1): 124 - 130. [Abstract] [Full Text]

				R. M. Mayberry, F. Mili, and E. Ofili Racial and Ethnic Differences in Access to Medical Care Med Care Res Rev, December 1, 2000; 57(4_suppl): 108 - 145. [Abstract] [PDF]

				C. H. MacLean, R. Louie, B. Leake, D. F. McCaffrey, H. E. Paulus, R. H. Brook, and P. G. Shekelle Quality of Care for Patients With Rheumatoid Arthritis JAMA, August 23, 2000; 284(8): 984 - 992. [Abstract] [Full Text] [PDF]

				M. B. Davidson, V. J. Karlan, and T. L. Hair Effect of a Pharmacist-Managed Diabetes Care Program in a Free Medical Clinic American Journal of Medical Quality, July 1, 2000; 15(4): 137 - 142. [Abstract] [PDF]

				S. A. Brown, R. B. Harrist, E. T. Villagomez, M. Segura, S. A. Barton, and C. L. Hanis Gender and Treatment Differences in Knowledge, Health Beliefs, and Metabolic Control in Mexican Americans With Type 2 Diabetes The Diabetes Educator, May 1, 2000; 26(3): 425 - 438. [PDF]

				P. S. Via and J. Salyer Psychosocial Self-Efficacy and Personal Characteristics of Veterans Attending a Diabetes Education Program The Diabetes Educator, September 1, 1999; 25(5): 727 - 737. [Abstract] [PDF]

				M. T. Donohoe Comparing Generalist and Specialty Care: Discrepancies, Deficiencies, and Excesses Arch Intern Med, August 10, 1998; 158(15): 1596 - 1608. [Abstract] [Full Text]

				R. M. Anderson and K. Wisdom Into the Heart of Darkness: Reflections on Racism and Diabetes Care and The Healing Process: Reflections on African American History and Diabetes Care The Diabetes Educator, January 1, 1998; 24(6): 689 - 692. [PDF]