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Dissertation/Thesis Abstract

Healthcare Disparities in Diabetic Care
by McMahill-Walraven, Cheryl N., Ph.D., Northcentral University, 2011, 208; 3452476
Abstract (Summary)

Healthcare disparities, or differences among racial and ethnic groups, exist across the healthcare continuum. Governmental entities and private institutions issued challenges to the healthcare community to reduce healthcare differences. The problem examined in this quantitative quasi-experimental trend study was the change in healthcare disparity over a 10-year period for good control of glucose, blood pressure, and low-density lipoprotein (LDL) among Black, Hispanic, and White American diabetics. The randomly selected study population included 2,542 adult diabetic participants in National Health and Nutritional Examination Survey (NHANES) medical examination who were Black, Hispanic, or White. The dichotomous dependent variables were good control of glucose, blood pressure, and LDL. The independent variable was the interaction term racial and ethnic group and tune. The mediating health-related factors evaluated per dependent variable and accounted for in the multivariate logistic regressions were age, body weight index, education completed, gender, health insurance coverage, and household income. There were three key findings. One, the percentage of diabetics with good control of glucose, blood pressure, and LDL increased over the 10-year period. Two, mediating health-related factors had a statistically significant impact in the independent-dependent variable relationship. Three, the difference in the rates of good control between the racial and ethnic groups (disparity gap) changed over time. The disparity gap reduced for good glucose control between Black and White subgroups ( X2(4) = 19.26, p = 0.001) and Hispanic and White subgroups (X2(4) = 14.87, p = 0.005) as well as for good LDL control between Hispanic and White subgroups (X2(4) = 28.95, p < 0.001). The disparity gap expanded for good blood pressure control between Black and White diabetics (X2(4) = 28.83, p < 0.001) and Hispanic and White subgroups (X 2(4) = 23.84, p < 0.001) as well as for good LDL control between Black and White subgroups (X2(4) = 21.25, p < 0.001). Conclusions were limited to non-causal interpretations. Further study recommendations included the identification of techniques to improve diabetic control of glucose, blood pressure, and LDL; evaluation and use of mediating health-related factors in disparities research; and, replication of the study techniques with other health conditions.

Indexing (document details)
Advisor: Mustard, Lewis
School: Northcentral University
School Location: United States -- Arizona
Source: DAI-B 72/06, Dissertation Abstracts International
Subjects: African American Studies, Hispanic American studies, Health care management
Keywords: Diabetic care, Disparity gaps, Ethnic groups, Healthcare differences, Healthcare disparities
Publication Number: 3452476
ISBN: 978-1-124-59326-5
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