Diabetes Care Often Fails Rural, Minority Patients – Medscape
Like real estate, the quality of diabetes care comes down to “location, location, location,” a large cohort study led by a team from Mayo Clinic, Rochester, Minnesota, has found.
Adults with diabetes who live in rural areas, as well as those who live in areas of socioeconomic disadvantage, were much less likely to achieve optimal diabetes care than people who live in urban areas and in less socioeconomically deprived areas. Outcomes were even worse among racial and eth…….
Like real estate, the quality of diabetes care comes down to “location, location, location,” a large cohort study led by a team from Mayo Clinic, Rochester, Minnesota, has found.
Adults with diabetes who live in rural areas, as well as those who live in areas of socioeconomic disadvantage, were much less likely to achieve optimal diabetes care than people who live in urban areas and in less socioeconomically deprived areas. Outcomes were even worse among racial and ethnic minority groups, according to the researchers, whose findings appeared December 29 in JAMA Network Open.
“High costs of diabetes medications, testing supplies, and appointments, as well as difficulty receiving needed medical care for their diabetes all contribute to the gaps in diabetes care quality among people in deprived areas,” said Rozalina G. McCoy, MD, associate professor of medicine in Mayo Clinic’s Division of Community Internal Medicine, Geriatrics, and Palliative Care, and the principal investigator on the study. “As clinicians and health systems, we need to better understand the challenges our patients face every day and work with them to help them overcome them.”
‘We’re never going to get control of this diabetes animal if we’re just throwing drugs at it.’
Alan Reisinger III, MD, associate medical director for MDVIP, a Boca Raton, Florida-based operator of a network of physicians providing preventive care and personalized primary care, called the new study “well-done and necessary.”
Reisinger, who is spearheading an effort to teach physicians how to prevent diabetes, strokes, and heart attacks, added that more patient education is needed starting in primary school to prevent diabetes.
“We’re never going to get control of this diabetes animal if we’re just throwing drugs at it,” Reisinger told Medscape Medical News. “In the typical primary care practice, where you have 8 to 10 minutes to spend with a patient, there just simply isn’t the time for the type of health coaching that would be the most effective to manage a diabetic or pre-diabetic patient.”
The study examined medical records of 31,934 patients with diabetes between 18 and 75 years of age cared for in 75 primary care practices across Minnesota, Iowa, and Wisconsin.
McCoy and her colleagues used data from the US Census American Community Survey to calculate area-level deprivation (ADI) for the US Census block groups where patients live and their zip codes to determine if the area is rural or urban. ADI is a measure of socioeconomic deprivation that reflects the income, employment, housing, and education levels of people living in a particular geographic region.
To assess the quality of care in rural and urban settings, as well as different levels of socioeconomic deprivation, the researchers used the “D5” — a composite measure of comprehensive diabetes treatment. Achieving the …….
