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Ethnic Differences in Quality of Life in Insured Older Adults with Diabetes Mellitus in an Integrated Delivery System
Author(s) -
Laiteerapong Neda,
Karter Andrew J.,
John Priya M.,
Schillinger Dean,
Moffet Howard H.,
Liu Jennifer Y.,
Adler Nancy,
Chin Marshall H.,
Huang Elbert S.
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12327
Subject(s) - medicine , ethnic group , diabetes mellitus , gerontology , quality of life (healthcare) , nursing , endocrinology , sociology , anthropology
Objectives To explore racial and ethnic (ethnic hereafter) differences in health‐related quality of life ( HRQL ) in older adults with diabetes mellitus in an integrated delivery system. Design Observational cross‐sectional study. Setting Kaiser P ermanente N orthern C alifornia. Participants Ethnic‐stratified, random sample of 6,096 adults with diabetes mellitus aged 60 to 75 who completed a HRQL questionnaire. Measurements Physical and mental HRQL were measured based on the M edical O utcomes S tudy 8‐item S hort F orm S urvey (range 0–100, mean 50). Age‐ and sex‐adjusted weighted linear regression models estimated associations between ethnicity and HRQL and evaluated potential mediators (socioeconomic status, acculturation, health behaviors, diabetes mellitus–related conditions). Differences in ethnic‐specific, adjusted mean HRQL scores were tested (reference whites). Results Physical HRQL was better for F ilipinos (48.3, 95% confidence interval ( CI ) = 47.0–49.6, P < .001), Asians (48.1, 95% CI = 46.8–49.3, P < .001), Hispanics (45.1, 95% CI = 44.2–46.0, P < .001), and blacks (44.2, 95% CI = 43.3–45.1, P = .04) than whites (42.9, 95% CI = 42.6–43.2). Adjusting for potential mediators did not change these relationships. Mental HRQL was better only for A sians (52.7, 95% CI = 51.6–53.7, P = .01) than for whites (51.0, 95% CI = 50.7–51.3), but this difference was small and became nonsignificant after adjustment for socioeconomic status, acculturation, health behaviors, and diabetes mellitus–related conditions. Conclusion In older adults with diabetes mellitus in a well‐established integrated healthcare delivery system, ethnic minorities had better physical HRQL than whites. Equal access to care in an integrated delivery system may hold promise for reducing health disparities in diabetes mellitus‐related patient‐reported outcomes.