Trends in sex differences in the receipt of quality of care indicators among adults with diabetes: United States 2002-2011

BMC Endocrine Disorders

Research Article

Alessandra St. Germain¹  Kinfe G. Bishu²  Leonard E. Egede³  Joni S. Williams³ 

[1] Center for Health Disparities Research, Department of Medicine, Medical University of South Carolina, 135Rutledge Avenue, Room 280, MSC 250593, SC 29425, Charleston, USA;Center for Health Disparities Research, Department of Medicine, Medical University of South Carolina, 135Rutledge Avenue, Room 280, MSC 250593, SC 29425, Charleston, USA;Department of Medicine, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, 171 Ashley Avenue, SC 29425, Charleston, USA;Department of Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Clinical Cancer Center Building Suite C5400, WI 53226, Milwaukee, USA;Center for Patient Care and Outcomes Research (PCOR), Medical College of Wisconsin, WI 53226, Milwaukee, USA;Division of General Internal Medicine, Center for Patient Care and Outcomes Research, Medical College ofWisconsin, 9200 W. Wisconsin Ave, WI 53226, Milwaukee, USA;

关键词: Sex differences;    Diabetes;    Quality of care;    Adults;    Disparity;   

DOI  :  10.1186/s12902-017-0183-5

 received in 2016-10-27, accepted in 2017-05-31,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundEvidence suggests disparities in quality of care (QoC) indicators based on sex exist in adults diagnosed with diabetes; however, this research is limited. Therefore, the objective of this research study was to assess differences in QOC indicators in a nationally representative sample of men and women with diabetes.MethodsCross-sectional study of 17,702 men and women (≥18 years of age) with diabetes from the 2002–2011 Medical Expenditure Panel Survey Household Component. Sex was the main predictor variable, and the dependent variables were five binary indicators to measure QOC, which included testing of hemoglobin A1c, examining feet annually, getting eyes dilated, checking blood pressure, and visiting the doctor annually. Sample demographics by sex were assessed. Unadjusted analyses were computed for descriptive statistics by sex and proportions of QOC indicators over time. Logistic regression evaluated associations between QOC indicators and sex, while controlling for sociodemographic characteristics, time, and comorbid conditions.ResultsApproximately 44% and 56% of the sample was comprised of men and women, respectively. Unadjusted analyses showed significant differences in A1c testing (p < 0.001) and foot examinations (p = 0.002) for the entire sample, and significant differences in A1c testing (p = 0.027), foot examinations (p = 0.01), and dilated eye exams (p = 0.026) among men and A1c testing (p < 0.001) among women overtime. Adjusted analyses found women to be significantly more likely to have dilated eye examinations during a given year (OR = 1.14; 95% CI 1.04, 1.24), to get their blood pressure checked by a doctor in a given year (OR = 1.44; 95% CI 1.13, 1.84), and to visit a doctor annually (OR = 1.39; 95% CI 1.22, 1.58) compared to men.ConclusionsIn this sample of adults with diabetes, women had significantly higher odds of receiving quality of care compared to men. These findings suggest the importance of educating patients about appropriate metrics of diabetes management, especially men, and the need for continuous empowerment of women to receive proper and optimal care. Additional research is needed to identify causes and reduce sex and gender disparities associated with diabetes quality of care.

【 授权许可】

CC BY   
© The Author(s). 2017