Lack of Lipid Screening Disparities in Obese Latino Adults at Health Centers
Lack of Lipid Screening Disparities in Obese Latino Adults at Health Centers
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DOI：
10.1016/j.amepre.2016.12.020
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发表时间：
2017-06-01
影响因子：
5.5
通讯作者：
Marino, Miguel
中科院分区：
文献类型：
--
作者：
Heintzman, John D.;Bailey, Steffani R.;Marino, Miguel
引言：在横断面调查研究中，尽管肥胖的拉丁裔患高脂血症和冠状动脉疾病的风险较高，但他们接受血清胆固醇升高筛查的可能性较低。本研究利用电子健康记录数据，评估了俄勒冈社区卫生中心（CHC）5年间肥胖的拉丁裔和非西班牙裔白人患者在血脂筛查接受情况方面的保险以及种族/族裔差异。
方法：这项回顾性队列研究评估了2009 - 2013年期间在俄勒冈社区卫生中心至少就诊一次的肥胖（体重指数≥30）、低收入的成年患者（年龄21 - 79岁）（n = 11,095）。测量了研究期间（2009 - 2013年收集的临床数据）进行血脂筛查的几率，并根据年龄、性别、主要就诊诊所和合并症进行调整，同时按研究期间的就诊次数分层。分析于2016年完成。
结果：在2009 - 2013年期间，60%的研究人群至少接受了一次血脂筛查。在有保险的拉丁裔和有保险的非西班牙裔白人之间，除了5年间就诊次数超过5次的人群外，筛查情况没有显著差异（比值比=0.75，95%置信区间=0.60，0.94）。在低就诊次数层中，未参保的拉丁裔与有保险的非西班牙裔白人相比，筛查几率更高（比值比=1.65，95%置信区间=1.18，2.30）。在拉丁裔中，在就诊2 - 5次层中，偏好西班牙语的人群与偏好英语的人群相比，筛查几率更高（比值比=1.63，95%置信区间=1.12，2.35）。
结论：社区卫生中心的肥胖、低收入患者未充分利用胆固醇筛查。然而，种族/族裔和偏好语言导致的筛查差异很小。有必要进一步研究以了解社区卫生中心提供的医疗服务如何减轻先前报道的血脂筛查差异。（C）2017年《美国预防医学杂志》。由爱思唯尔公司出版。保留所有权利。
Introduction: In cross-sectional survey studies, obese Latinos are less likely to be screened for elevated serum cholesterol, despite their higher risk for hyperlipidemia and coronary artery disease. This study evaluated insurance and racial/ethnic disparities in lipid screening receipt between obese Latino and non-Hispanic white patients in Oregon community health centers (CHCs) over 5 years, using electronic health record data.Methods: This retrospective cohort study evaluated obese (BMI >= 30), low-income, adult patients (aged 21-79 years) with at least one visit at an Oregon CHC during 2009-2013 (n=11,095). Odds of lipid screening in the study period (clinical data collected in 2009-2013) were measured, adjusting for age, sex, primary clinic, and comorbidities, stratified by utilization in the study period. Analysis was done in 2016.Results: Sixty percent of the study population received at least one lipid screening in 2009=2013. There were no significant differences in screening between insured Latinos and insured nonHispanic whites, except those with more than five visits over 5 years (OR=0.75, 95% CI=0.60, 0.94). Uninsured Latinos had higher odds of screening versus insured non-Hispanic whites among the low visit strata (OR=1.65, 95% CI=1.18, 2.30). Among Latinos, Spanish preference resulted in higher screening odds versus English preference in the two-to five-visit stratum (OR=1.63, 95% CI=1.12, 2.35).Conclusions: Obese, low-income patients at CHCs underutilize cholesterol screening. However, screening differences by race/ethnicity and preferred language are minimal. Further research is necessary to understand how care delivered by CHCs may mitigate previously reported disparities in lipid screening. (C) 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.