Ethnic disparities in diabetic complications in an insured population
Ethnic disparities in diabetic complications in an insured population
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DOI：
10.1001/jama.287.19.2519
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发表时间：
2002-05-15
影响因子：
120.7
通讯作者：
Selby, JV
中科院分区：
文献类型：
--
作者：
Karter, AJ;Ferrara, A;Selby, JV
据报道，少数民族的微血管并发症发生率较高。获得优质医疗保健的机会不同是美国人群中糖尿病并发症发生率种族差异的常见解释。检查一个种族多样化的人口与统一的医疗保健coverage may be useful.Objective To assess ethnic diabetes diseases in the incidence of diabetes complications within a nonprofit prepaid health care organization.Design and Setting纵向观察研究进行了1月1日，1995，通过12月31日，1998，研究对象：62432名糖尿病患者，包括亚洲人（12%），黑人（14%），拉丁美洲人（10%），主要结果测量事件心肌梗死（MI）、中风、充血性心力衰竭（CHF）和非创伤性下肢截肢（莱亚），由主要住院出院诊断、手术或潜在死亡原因定义;和终末期肾病（ESRD），定义为肾功能不全，需要肾脏替代治疗或移植生存或潜在的死亡原因。不同并发症之间的差异并不一致，尽管对广泛的人口统计学、社会经济学、行为学和临床因素进行了调整，但差异仍经常持续存在。黑人、亚洲人和拉丁美洲人校正后的风险比（相对于白人）分别为0.56、0.68和0.68（P
Context Higher rates of microvascular complications have been reported for minorities. Disparate access to quality health care is a common explanation for ethnic disparities in diabetic complication rates in the US population. Examining an ethnically diverse population with uniform health care coverage may be useful.Objective To assess ethnic disparities in the incidence of diabetic complications within a nonprofit prepaid health care organization.Design and Setting Longitudinal observational study conducted January 1, 1995, through December 31, 1998, at Kaiser Permanente Medical Care Program in northern California.Participants A total of 62432 diabetic patients including Asians (12%), blacks (14%), Latinos (10%), and whites (64%).Main Outcome Measures Incident myocardial infarction (MI), stroke, congestive heart failure (CHF), and nontraumatic lower extremity amputation (LEA), defined by primary hospitalization discharge diagnosis, procedures, or underlying cause of death; and end-stage renal disease (ESRD), defined as renal insufficiency requiring renal replacement therapy or transplantation for survival or by underlying cause of death.Results Patterns of ethnic differences were not consistent across complications and frequently persisted despite adjustment for a wide range of demographic, socioeconomic, behavioral, and clinical factors. Adjusted hazard ratios (relative to that of whites) were 0.56, 0.68, and 0.68 for blacks, Asians, and Latinos, respectively (P