Sex Differences in Quality of Health Care Related to Ischemic Heart Disease Prevention in Patients With Diabetes
The Translating Research Into Action for Diabetes (TRIAD) study, 2000–2001
- Assiamira Ferrara, MD, PHD1,
- David F. Williamson, PHD2,
- Andrew J. Karter, PHD1,
- Theodore J. Thompson, MS2,
- Catherine Kim, MD, MPH3 and
- for the TRIAD Study Group
- 1Division of Research, Northern California Kaiser Permanente Medical Care Program, Oakland, California
- 2Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia
- 3Departments of Internal Medicine and Obstetrics and Gynecology, Division of General Medicine, University of Michigan, Ann Arbor, Michigan
- Address correspondence and reprint requests to Assiamira Ferrara, MD, PhD, Division of Research, Northern California Kaiser Permanente Medical Care Program, 2000 Broadway, Oakland, CA 94612. E-mail: axf{at}dor.kaiser.org
Diabetes is a greater risk factor for ischemic heart disease (IHD) in women than in men (1,2). In the U.S., IHD-related mortality has declined among men with and without diabetes (3). Among women, a decrease in IHD-related mortality has been observed only for those without diabetes (3). This difference may be attributable to biological (4) and behavioral factors (5) or possibly differences in the quality of health care received (3). We investigated whether there were differences between men and women regarding the quality of health care related to IHD prevention in a population-based cohort of patients with diabetes, aged 20–80 years and sampled from 10 managed care health plans and 68 provider groups in the U.S. (6).
RESEARCH DESIGN AND METHODS
Participants were surveyed using a standardized computer-assisted telephone interview or self-administered written instrument. Of contacted eligible people, 91% responded to the survey. We examined data from the participants for whom medical records were available to document diabetes care. Interrater reliability (κ) for the main quality measures derived from medical record data ranged from 0.85 to 0.92. The quality of diabetes care related to IHD prevention received by patients during a 12-month period was measured by the frequency of selected process of care measurements: 1) current use of …
