Journal of Public Health Advance Access published online on June 3, 2008
Journal of Public Health, doi:10.1093/pubmed/fdn042
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Utilization of physician services for diabetic patients from ethnic minorities
Baiju R. Shah, Assistant Professor1,2,3,4
1 Institute for Clinical Evaluative Sciences, G106-2075 Bayview Avenue, Toronto, ON, Canada M4 N 3M5
2 Department of Medicine, University of Toronto, Toronto, ON, Canada
3 Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
4 Sunnybrook Health Sciences Centre, Toronto, ON, Canada
Address correspondence to Baiju R. Shah, E-mail: baiju.shah{at}ices.on.ca
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Abstract |
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Background Diabetes is a common chronic disease, which results in significant morbidity and mortality. Although ethnic variations in disease prevalence are known, variations in the utilization of physician services for the disease (particularly in publicly funded health care systems) are uncertain.
Methods Self-reported ethnicity was determined from two population health surveys in Ontario, Canada. These data were linked to administrative data sources, including an administrative data-derived disease registry. Diabetes prevalence was determined for each ethnic group. Utilization of physician services for primary care, diabetes specialist care and eye examinations was compared among ethnic groups, adjusting for age, sex, socioeconomic status and diabetes duration.
Results There were 20 788 eligible survey respondents. Standardized diabetes prevalence was elevated for the South Asian and Black populations (11.1 and 11.0%, respectively) compared with that for the White population (5.9%). Ethnic minorities with diabetes were less likely to receive an eye examination compared with White patients (adjusted OR, 0.63; 95% CI, 0.46–0.85). The use of primary care and diabetes specialist care did not differ.
Conclusion Ethnic minorities with diabetes are less likely to receive eye examinations. This disparity in quality of care could lead to worse clinical outcomes for these patients.
Keywords: diabetes, ethnicity, health services