Quality of care for patients with type 2 diabetes in general practice according to patients ethnic background: a cross-sectional study from Oslo, NorwayReport as inadecuate




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BMC Health Services Research

, 10:145

First Online: 28 May 2010Received: 25 September 2009Accepted: 28 May 2010DOI: 10.1186-1472-6963-10-145

Cite this article as: Tran, A.T., Diep, L.M., Cooper, J.G. et al. BMC Health Serv Res 2010 10: 145. doi:10.1186-1472-6963-10-145

Abstract

BackgroundIn recent decades immigration to Norway from Asia, Africa and Eastern Europe has increased rapidly. The aim of this study was to assess the quality of care for type 2 diabetes mellitus T2DM patients from these ethnic minority groups compared with the care received by Norwegians.

MethodsIn 2006, electronic medical record data were screened at 11 practices 49 GPs; 58857 patients. 1653 T2DM patients cared for in general practice were identified. Ethnicity was defined as self-reported country of birth. Chi-squared tests, one-way ANOVAs, multiple regression, linear mixed effect models and generalized linear mixed models were used.

ResultsDiabetes was diagnosed at a younger age in patients from the ethnic minority groups South Asians SA: mean age 44.9 years, Middle East-North Africa MENA: 47.2 years, East Asians EA: 52.0 years, others: 49.0 years compared with Norwegians 59.7 years, p < 0.001. HbA1c, systolic blood pressure SBP and s-cholesterol were measured in >85% of patients in all groups with minor differences between minority groups and Norwegians. A greater proportion of the minority groups were prescribed hypoglycaemic medications compared with Norwegians ≥79% vs. 72%, p < 0.001. After adjusting for age, gender, diabetes duration, practice and physician unit, HbA1c geometric mean for Norwegians was 6.9% compared to 7.3-7.5% in the minority groups p < 0.05. The proportion with poor glycaemic control HbA1c > 9% was higher in minority groups SA: 19.6%, MENA: 18.9% vs. Norwegians: 5.6%, p < 0.001. No significant ethnic differences were found in the proportions reaching the combined target: HbA1c ≤ 7.5%, SBP ≤ 140 mmHg, diastolic blood pressure DBP ≤ 85 mmHg and total s-cholesterol ≤5.0 mmol-L Norwegians: 25.5%, SA: 24.9%, MENA: 26.9%, EA: 26.1%, others:17.5%.

ConclusionsMean age at the time of diagnosis of T2DM was 8-15 years younger in minority groups compared with Norwegians. Recording of important processes of care measures is high in all groups. Only one in four of most patient groups achieved all four treatment targets and prescribing habits may be sub-optimal. Patients from minority groups have worse glycaemic control than Norwegians which implies that it might be necessary to improve the guidelines to meet the needs of specific ethnic groups.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-10-145 contains supplementary material, which is available to authorized users.

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Author: Anh T Tran - Lien M Diep - John G Cooper - Tor Claudi - Jørund Straand - Kåre Birkeland - Wibeche Ingskog - Anne K J

Source: https://link.springer.com/







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