TY - JOUR
T1 - Association of a housing based individual socioeconomic status measure with diabetic control in primary care practices
AU - Greenwood, Jason
AU - Zurek, Kaitlyn I.
AU - Grimm, Jade M.
AU - Wi, Chung Il
AU - Vogel, John T.
AU - Garrison, Gregory M.
N1 - Funding Information:
Funding was provided by the National Center for Advancing Translational Sciences grant ( #UL1 TR002377 ) thru the Department of Family Medicine, Mayo Clinic Small Grants Program (<$10k) and from the Minnesota Academy of Family Physicians Resident Research Award ( #FP00105876 ). The department and MAFP reviewed the scientific merit of the proposed work but had no role in the design, data collection, analysis, interpretation, or reporting of the study results.
Publisher Copyright:
© 2021 Primary Care Diabetes Europe
PY - 2021
Y1 - 2021
N2 - Aims: Socioeconomic status (SES) is an important variable that impacts healthcare outcomes. However, grouped SES data is not always representative of all members and it is difficult to obtain individual level data. A validated individual housing-based measure termed HOUSES is available, but has not been studied in diabetes. We hypothesize that patients in the lowest HOUSES quartile are associated with worse diabetic control as measured by the D5. Methods: A retrospective cohort study of 5463 patients with diabetes in 5 patient centered medical home practices in southeast Minnesota was conducted. HOUSES is a validated, standardized housing-based SES measure constructed from publicly available county assessor's office data. Diabetic control was assessed by the D5 (HgbA1c < 8, BP < 140/90, statin use, nonsmoking status, and antiplatelet therapy). Results: In the lowest HOUSES quartile, more patients had an uncontrolled D5 (56.4%) than any of the other quartiles (49.2%, 49.8%, 49.6% respectively, p < 0.001). A multivariate analysis shows the adjusted odds of D5 control for patients in the 2nd, 3rd or 4th HOUSES quartiles as opposed to the 1st quartile are 1.28, 1.21, and 1.20, respectively. Conclusion: Lower SES as represented by the first quartile of HOUSES index, is associated with lower odds of D5 control and thus worse diabetic outcomes. Using the HOUSES index to identify these individuals in a patient centered medical home might prove useful in deciding where to focus diabetic control efforts.
AB - Aims: Socioeconomic status (SES) is an important variable that impacts healthcare outcomes. However, grouped SES data is not always representative of all members and it is difficult to obtain individual level data. A validated individual housing-based measure termed HOUSES is available, but has not been studied in diabetes. We hypothesize that patients in the lowest HOUSES quartile are associated with worse diabetic control as measured by the D5. Methods: A retrospective cohort study of 5463 patients with diabetes in 5 patient centered medical home practices in southeast Minnesota was conducted. HOUSES is a validated, standardized housing-based SES measure constructed from publicly available county assessor's office data. Diabetic control was assessed by the D5 (HgbA1c < 8, BP < 140/90, statin use, nonsmoking status, and antiplatelet therapy). Results: In the lowest HOUSES quartile, more patients had an uncontrolled D5 (56.4%) than any of the other quartiles (49.2%, 49.8%, 49.6% respectively, p < 0.001). A multivariate analysis shows the adjusted odds of D5 control for patients in the 2nd, 3rd or 4th HOUSES quartiles as opposed to the 1st quartile are 1.28, 1.21, and 1.20, respectively. Conclusion: Lower SES as represented by the first quartile of HOUSES index, is associated with lower odds of D5 control and thus worse diabetic outcomes. Using the HOUSES index to identify these individuals in a patient centered medical home might prove useful in deciding where to focus diabetic control efforts.
KW - Diabetes
KW - Patient centered medical home
KW - Socioeconomic status
UR - http://www.scopus.com/inward/record.url?scp=85119518588&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85119518588&partnerID=8YFLogxK
U2 - 10.1016/j.pcd.2021.10.001
DO - 10.1016/j.pcd.2021.10.001
M3 - Article
AN - SCOPUS:85119518588
JO - Primary Care Diabetes
JF - Primary Care Diabetes
SN - 1751-9918
ER -