REGIONAL VARIATIONS IN THE DISTRIBUTION AND CLINICAL DIAGNOSIS OF DIABETES AMONG BLACKS IN THE UNITED STATES
Currently, an estimated 10.3 million people in the U.S. have been diagnosed with diabetes (types I and II)-- a sixfold increase over the past four decades. More challenging for public health is that another 5.4 million Americans have undiagnosed diabetes. Diabetes is the third leading cause of death among Blacks in the United States, exceeded only by cardiovascular and cancer. The purpose of this study is to examine the patterns of diagnostic clinical procedures received by Black diabetic patients in the U.S.. A data set of over 30,000 Black diabetic patients discharged from short-stay non-federal hospitals between 1990 and 1998 was created from the National Hospital Discharge Survey (NHDS). Frequency and cross-tabulation analyses of the dataset was conducted. International Classification of Diseases (ICD-9) and ICD-9-CM codes were used to examine diagnosis / complications and clinical procedures. Majority (48 %) of Black diabetic patients were in the South region, but hospitals in the Northeast performed the most diagnostic procedures (NE=3.5 vs So=1.22 per patient, p< 0.001); approximately 60% received care at small hospitals (< 300 beds); majority (68%) were discharged without a diabetic complication – ophthalmic complications were the most prevalent. Women experienced more complications than men. Implications of these findings for reducing disparities in the diagnosis/clinical management of Black diabetic patients through targeted health promotion and monitoring of the quality and adequacy of clinical care will be discussed.
Learning Objectives: Objectives of the study are to: 1) profile the geographic distribution of Black diabetic patients; 2) examine regional variations in source and types of hospital care for Black diabetic patients; and 3) assess adequacy of diagnostic procedures provided by hospitals of various sizes and geographic locations in treating the patients.
Keywords: Diabetes,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.