Measuring Racial Disparities in the Quality of Ambulatory Diabetes Care

摘要: Background: Improving the health of minority patients who have diabetes depends in part on improving quality and reducing disparities ambulatory care. It has been difficult to measure these components at level actionable units. Objective: To care racial across groups physicians for populations patients. Research Design: Prospective cohort analysis using administrative data. Subjects: Using fee-for-service Medicare claims data from 2003 2005, we link their principal physician. The are then linked hospital where work or admitted, creating physician-hospital networks. Measures: Proportion recommended testing received by black nonblack Results: Blacks 70% compared with nonblacks 76.9% (P 0.001). However, patients, variation exceeds gap treatment. network-specific performance rates blacks were highly correlated (r 0.67, P 0.001), but 47% blacks, versus 31% nonblacks, third networks lowest quality. Physician-hospital higher overall quality, socioeconomic status, no less likely exhibit black-white disparities. Conclusions: is possible measure, benchmark, monitor responsible Consequently, it should be easier provide information network design policies that improve minority-serving providers.