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Differences in the quality of diabetes care caused by social inequalities disappear after treatment and education in a tertiary care centre
Author(s) -
Bäz L.,
Müller N.,
Beluchin E.,
Kloos C.,
Lehmann T.,
Wolf G.,
Müller U. A.
Publication year - 2012
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2011.03455.x
Subject(s) - medicine , tertiary care , inequality , diabetes mellitus , quality (philosophy) , family medicine , gerontology , endocrinology , mathematical analysis , philosophy , mathematics , epistemology
Diabet. Med. 29, 640–645 (2012) Abstract Aim To assess the relationship between social status and quality of diabetes care in a tertiary care centre in Germany. Methods Social status was assessed in 940 consecutive patients in a university outpatient department by a questionnaire. The assessment comprised three components: education, highest professional position and household net income (total score 3–21). Quality of diabetes care was measured by HbA 1c , blood pressure and BMI. The influence of social status on quality measures was analysed at entry and last visit by fitting linear mixed models. Results At the entry visit, patients with lower social status had a higher HbA 1c compared with patients with higher status (0.06% per each point of social score difference). After a mean follow‐ up of 6.0 years (Type 2 diabetes) and 9.4 years (Type 1 diabetes) no significant differences in HbA 1c could be found. However, difference in BMI (−0.41 kg/m² per each point of social score) persisted at last observation. Blood pressure was only negligibly affected by the care programme. Conclusions Low social status is associated with worse quality of diabetes care at entry in a tertiary care centre. The differences in HbA 1c disappeared after treatment and structured education, whereas the difference in BMI persisted. There was no significant influence of social status or treatment on blood pressure.