The Association Between Clinical Care Strategies and the Attenuation of Racial/Ethnic Disparities in Diabetes Care

The Translating Research Into Action for Diabetes (TRIAD) Study

Datos Bibliográficos

ID9099751
AutoresO Kenrik Duru (0000-0001-8825-9460, Pacific Health Research and Education Institute, autor de correspondencia), Carol M Mangione (0000-0002-9475-2275, University of California, Los Angeles, autor de correspondencia), Neil W Steers, Neil Steers (Pacific Health Research and Education Institute, autor de correspondencia), William H Herman (0000-0002-0502-674X, University of Michigan), Andrew J Karter (0000-0001-5527-316X, Kaiser Permanente), David Kountz, David S Kountz (Johnson University), David G Marrero (0000-0003-2112-7812, Indiana University School of Medicine), Monika M Safford (0000-0002-3060-0563, University of Alabama at Birmingham), Beth Waitzfelder, Beth E Waitzfelder (University of California, Los Angeles, autor de correspondencia), Robert B Gerzoff (0000-0002-4538-6109, University of Michigan), Soonim Huh (University of California, Los Angeles, autor de correspondencia), Arleen F Brown (0000-0001-9948-8955, University of California, Los Angeles, autor de correspondencia)
Año2006
Volumen44
Número12
Páginas1121-1128
Fecha de publicación2006-12-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000237423.05294.c0
PMID17122717
OpenAlexW2054938115
IdiomaEN
Citas recibidas5
Referencias citadas36

OBJECTIVE: We sought to determine whether greater implementation of clinical care strategies in managed care is associated with attenuation of known racial/ethnic disparities in diabetes care. RESEARCH DESIGN AND METHODS: Using cross-sectional data, we examined the quality of diabetes care as measured by frequencies of process delivery as well as medication management of intermediate outcomes, for 7426 black, Latinos, Asian/Pacific Islanders, and white participants enrolled in 10 managed care plans within 63 provider groups. We stratified models by intensity of 3 clinical care strategies at the provider group level: physician reminders, physician feedback, or use of a diabetes registry. RESULTS: Exposure to clinical care strategy implementation at the provider group level varied by race and ethnicity, with <10% of black participants enrolled in provider groups in the highest-intensity quintile for physician feedback and <10% of both black and Asian/Pacific Islander participants enrolled in groups in the highest-intensity quintile for diabetes registry use. Although disparities in care were confirmed, particularly for black relative to white subjects, we did not find a consistent pattern of disparity attenuation with increasing implementation intensity for either processes of care or medication management of intermediate outcomes. CONCLUSIONS: For the most part, high-intensity implementation of a diabetes registry, physician feedback, or physician reminders, 3 clinical care strategies similar to those used in many health care settings, are not associated with attenuation of known disparities of diabetes care in managed care

Diabetes management · Diabetes mellitus · Environmental health · Ethnic group · Family medicine · Health care · Health equity · Managed care · MEDLINE · Pacific islanders · Population · Public health · Type 2 diabetes · Cultural Competency in Health Care · Diabetes Management and Education · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology