Abstract
Limited access to health care is associated with adverse outcomes, but few studies have examined its effect on glycemic control in minority populations. Our observational cross-sectional study examined whether differences in health care access affected hemoglobin A1c (HbA1c) levels in 605 patients with diabetes (56% women; 89% African American; average age, 50 years; 95% with type 2 diabetes) initially treated at a municipal diabetes clinic. Patients who had difficulty obtaining care had higher A1c levels (9.4% vs. 8.7%; p=0.001), as did patients who used acute care facilities (9.5%; p<0.001) or who had no usual source of care (10.3%; p<0.001) compared with those who sought care at doctors' offices or clinics (8.6%). In adjusted analyses, HbA1c was higher in persons who gave a history of trouble obtaining medical care (0.57%; p=0.04), among persons who primarily used an acute care facility to receive their health care (0.49%; p=0.047), and in patients who reported not having a usual source of care (1.08%; p=0.009). Policy decisions for improving diabetes outcomes should target barriers to health care access and focus on developing programs to help high-risk populations maintain a regular place of health care.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 734-746 |
| Number of pages | 13 |
| Journal | Journal of Health Care for the Poor and Underserved |
| Volume | 16 |
| Issue number | 4 |
| State | Published - Nov 2005 |
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Keywords
- African Americans
- Diabetes mellitus, type 2
- Glycemic control
- Health services accessibility
- Socioeconomic factors
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Health Policy
- Social Sciences (miscellaneous)
Cite this
Limited health care access impairs glycemic control in low socioeconomic status urban African Americans with type 2 diabetes. / Rhee, Mary K.; Cook, Curtiss B.; Dunbar, Virginia G.; Panayioto, Rita M.; Berkowitz, Kathy J.; Boyd, Barbara; George, Christopher D.; Lyles, Robert H.; El-Kebbi, Imad M.; Phillips, Lawrence S.
In: Journal of Health Care for the Poor and Underserved, Vol. 16, No. 4, 11.2005, p. 734-746.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Limited health care access impairs glycemic control in low socioeconomic status urban African Americans with type 2 diabetes
AU - Rhee, Mary K.
AU - Cook, Curtiss B.
AU - Dunbar, Virginia G.
AU - Panayioto, Rita M.
AU - Berkowitz, Kathy J.
AU - Boyd, Barbara
AU - George, Christopher D.
AU - Lyles, Robert H.
AU - El-Kebbi, Imad M.
AU - Phillips, Lawrence S.
PY - 2005/11
Y1 - 2005/11
N2 - Limited access to health care is associated with adverse outcomes, but few studies have examined its effect on glycemic control in minority populations. Our observational cross-sectional study examined whether differences in health care access affected hemoglobin A1c (HbA1c) levels in 605 patients with diabetes (56% women; 89% African American; average age, 50 years; 95% with type 2 diabetes) initially treated at a municipal diabetes clinic. Patients who had difficulty obtaining care had higher A1c levels (9.4% vs. 8.7%; p=0.001), as did patients who used acute care facilities (9.5%; p<0.001) or who had no usual source of care (10.3%; p<0.001) compared with those who sought care at doctors' offices or clinics (8.6%). In adjusted analyses, HbA1c was higher in persons who gave a history of trouble obtaining medical care (0.57%; p=0.04), among persons who primarily used an acute care facility to receive their health care (0.49%; p=0.047), and in patients who reported not having a usual source of care (1.08%; p=0.009). Policy decisions for improving diabetes outcomes should target barriers to health care access and focus on developing programs to help high-risk populations maintain a regular place of health care.
AB - Limited access to health care is associated with adverse outcomes, but few studies have examined its effect on glycemic control in minority populations. Our observational cross-sectional study examined whether differences in health care access affected hemoglobin A1c (HbA1c) levels in 605 patients with diabetes (56% women; 89% African American; average age, 50 years; 95% with type 2 diabetes) initially treated at a municipal diabetes clinic. Patients who had difficulty obtaining care had higher A1c levels (9.4% vs. 8.7%; p=0.001), as did patients who used acute care facilities (9.5%; p<0.001) or who had no usual source of care (10.3%; p<0.001) compared with those who sought care at doctors' offices or clinics (8.6%). In adjusted analyses, HbA1c was higher in persons who gave a history of trouble obtaining medical care (0.57%; p=0.04), among persons who primarily used an acute care facility to receive their health care (0.49%; p=0.047), and in patients who reported not having a usual source of care (1.08%; p=0.009). Policy decisions for improving diabetes outcomes should target barriers to health care access and focus on developing programs to help high-risk populations maintain a regular place of health care.
KW - African Americans
KW - Diabetes mellitus, type 2
KW - Glycemic control
KW - Health services accessibility
KW - Socioeconomic factors
UR - http://www.scopus.com/inward/record.url?scp=29244479176&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=29244479176&partnerID=8YFLogxK
M3 - Article
C2 - 16311495
AN - SCOPUS:29244479176
VL - 16
SP - 734
EP - 746
JO - Journal of Health Care for the Poor and Underserved
JF - Journal of Health Care for the Poor and Underserved
SN - 1049-2089
IS - 4
ER -