Racial Disparities Widespread in Diabetes Care
Systemwide efforts needed to ensure fair treatment of black diabetics, researchers conclude
TUESDAY, June 10 (HealthDay News) -- Racial disparities in diabetes outcomes are largely the result of variations in individual physicians' care of patients and, to a lesser extent, of sociodemographic factors, according to a report published in the June 9 issue of the Archives of Internal Medicine.
Thomas D. Sequist, M.D., of the Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues evaluated 6,814 diabetics treated by 90 primary care physicians in 13 ambulatory sites, using standard measures for evaluating intermediate outcomes in diabetics (hemoglobin A1c, low-density lipoprotein cholesterol and blood pressure). White patients were significantly more likely than blacks to have good control of their disease, the researchers found. Thirteen to 38 percent of racial differences in these measures were explained by patient sociodemographic factors. Some 66 to 75 percent were the result of variations in physicians' individual practices.
In a related study published in the May issue of the Journal of General Internal Medicine, Sequist and colleagues conducted a survey of 169 primary care physicians and nurse practitioners within a large group practice in 2007. The response rate was 86 percent. The researchers found that 88 percent acknowledged that racial disparities exist in treatment of diabetics in the United States, although only 40 percent said that such disparities existed in their own practices. A majority of respondents believed that patient factors were the biggest influence on racial disparities.
"Our data suggest that the problem of racial disparities is not characterized by only a few physicians providing markedly unequal care, but that such differences in care are spread across the entire system, requiring implementation of systemwide solutions," the authors write.
Several authors disclosed financial ties to pharmaceutical companies.