The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62685

Katharine H. Hendrix, MS, PhD(Cand)¹, Carolyn M. Jenkins, MSN, DRPH¹, and Deyi Zheng, MB, PhD². (1) REACH 2010, College of Nursing, Medical University of South Carolina, PO Box 250160, 99 Jonathan Lucas Street, Charleston, SC 29425, 843-792-5469, hendrikh@musc.edu, (2) Diabetes Initiative of South Carolina, Medical University of South Carolina, 135 Rutledge Ave, Room 273, Charleston, SC 29425

This study examines diabetes care at four clinics in South Carolina. Analyses focus on differences in care and outcomes by patient race and site. Chart audits were conducted at two clinics in one hospital and two Federally Qualified Health Centers. Representative, random samples were calculated from patient registries. Analyses reveal significant differences in care when data were stratified by race and site. By site, diagnostic tests differ significantly for lipid testing (range 63%-88%, p < 0.05) and kidney testing (range 12%-82%, p < 0.0001). Charts document significant variations in lab values for average HbA1c (range 7.5%- 8.7%, p < 0.0001), total cholesterol (range 191 mg/dl-217 mg/dl, p < 0.05), and blood pressures > 130/80 (range 51%-81%, p < 0.01). Preventive care differs by site for pneumonia vaccine (range 3%-26%, p < 0.0001), flu vaccine (range 10%-37%, p <0.005), diabetes education (range 67%-96%, p < 0.001), and nutrition education (range 56%-88%, p < 0.0001). Significant differences are found in Caucasians (C) and African Americans (AA) receiving eye exams (7% AA v. 42% C, p < 0.0001) and total cholesterol tests (67% AA v. 81% C, < 0.05). There are significant variations in average HbA1c (8.6% AA v. 7.6% C, p < 0.0001), total cholesterol (210 AA v. 205 C, p > 0.10), and blood pressures > 130/80 (78% AA v. 59% C, p < 0.01). Variations in tests, preventive care, and lab values among sites and by race are discussed. Participants will identify areas of diabetes care distribution and outcomes needing improvement.

Learning Objectives:

• Identify areas of racial inequity in diabetes health care. Identify diabetes outcomes needing improvement. Discuss differences in standards of care provided at four health care sites.

Keywords: Diabetes, Health Disparities

Presenting author's disclosure statement:
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.