Health Behaviors and Quality of Care Among Latinos With Diabetes in Managed Care
Arleen F. Brown, MD, PhD,
Robert B. Gerzoff, MS,
Andrew J. Karter, PhD,
Edward Gregg, PhD,
Monika Safford, MD,
Beth Waitzfelder, MA,
Gloria L. A. Beckles, MD, MSc,
Rebecca Brusuelas and
Carol M. Mangione, MD, MSPH for the TRIAD Study Group
Arleen F. Brown, Rebecca Brusuelas, and Carol M. Mangione are with the David Geffen School of Medicine at the University of California, Los Angeles. Robert B. Gerzoff, Edward Gregg, and Gloria L. Beckles are with the Centers for Disease Control and Prevention, Atlanta, Ga. Andrew J. Karter is with the Division of Research, Kaiser Permanente, Oakland, Calif. Monika Safford is with the University of Medicine and Dentistry of New JerseyNew Jersey Medical School, Newark, NJ. Beth Waitzfelder is with the Pacific Health Research Institute, Honolulu, Hawaii.
Correspondence: Requests for reprints should be sent to Arleen F. Brown, MD, PhD, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Campus Box 951736, Los Angeles, CA 90095-1736 (e-mail: abrown{at}mednet.ucla.edu).
Objectives. We evaluated whether ethnicity and language areassociated with diabetes care for Latinos in managed care.
Methods. Using data from 4685 individuals in the TranslatingResearch Into Action for Diabetes (TRIAD) Study, a multicenterstudy of diabetes care in managed care, we constructed multivariateregression models to compare health behaviors, processes ofcare, and intermediate outcomes for Whites and English- andSpanish-speaking Latinos.
Results. Latinos had lower rates of self-monitoring of bloodglucose and worse glycemic control than did Whites, higher ratesof foot self-care and dilated-eye examinations, and comparablerates of other processes and intermediate outcomes of care.
Conclusions. Although self-management and quality of care arecomparable for Latinos and Whites with diabetes, important ethnicdisparities persist in the managed care settings studied.
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