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TUESDAY, June 10 (HealthDay News) -- New research shows that black patients with diabetes tend to fare worse than white patients do, even if they see the same doctor.
In other words, the gap can't be explained by saying particular doctors tend to give substandard care. Racial disparities in diabetes care appear to be more the result of systemic issues, according to a study in the June 9 issue of the Archives of Internal Medicine.
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"It wasn't so much that black patients weren't receiving care from lower-quality providers," said study author Dr. Thomas D. Sequist, a primary-care physician at Harvard Vanguard Medical Associates. "Amongst all providers, black patients received lower quality care, even if white patients went to the same doctors."
"There have been some other studies that have shown just as much as who you are predicts what kind of care you get [race, income, gender], where you get care oftentimes is just as important or more important," Sequist continued.
Sequist and his co-authors wanted to see how far down the health-care system chain disparities went. Did it extend only to the hospital level, with some hospitals caring mostly for black patients providing lower quality care? Did the breakdown occur with individual physicians? Or was the problem even broader in scope?
This study looked at 90 primary-care physicians, each caring for at least five black and at least five white adult patients with type 2 diabetes. The physicians and patients were located at 13 different outpatient sites. In all, the study involved 4,556 white adults and 2,258 black adults being cared for at Harvard Vanguard Medical Associates.
White patients were more likely to achieve control of several key indicators of diabetes control: 47 percent of whites had control of hemoglobin A1c levels (an over-time measure of blood sugar levels) versus only 39 percent of blacks; 57 percent of whites had LDL ("bad") cholesterol levels in check, compared with 45 percent of blacks; and 30 percent of whites had their blood pressure in normal zones compared with 24 percent of blacks.
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