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Abstract

Although diabetes is more prevalent among Asian people, Asians with diabetes are anecdotally believed to receive a lesser standard of care, compared with non-Asians.

The aim of this study was to evaluate whether Asian patients with diabetes in Sandwell receive an inferior standard of care in primary care compared with non-Asians. Standards were based on tests carried out, in compliance with Sandwell's Diabetes Local Clinical Guideline. Data were collected from records of 774 patients with diabetes in 14 Sandwell practices. Proportions were recorded of Asian patients receiving specified tests, compared with non-Asians.

No significant differences were observed between Asians and non- Asians for checks on feet, eyes, body mass index (BMI), smoking or blood pressure. Significantly fewer Asians received an HbA_1c check. The mean HbA_1c value was higher in Asians. More Asian patients received a urine test than non-Asians. Asian patients generally had lower BMI values. When stratified by practice however, no significant differences between Asians and non-Asians were observed for any single check. No significant differences were found between the over all proportions of checks carried out between Asians and non-Asians. A wide variation was observed in the proportion of patients who had individual checks done, between practices.

There were no systematic differences in the standard of care given to Asian and non-Asian patients. Practices varied a great deal in the extent to which they carry out, and record, checks on patients with diabetes. A possible explanation for the reason that no summary result showed a significant difference was due to the confounding effect of the practice: that general practices tended to treat all their patients - Asian and non-Asian - similarly. Nevertheless, general prac titioners should therefore take steps to ensure that all patients with dia betes have these checks at recommended intervals.

Keywords

Asian origin diabetes diabetes care ethnicity primary care

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References

Bradshaw C. , Eccles M.P. , Steen I.N. and Choi H.Y. (1992). Work-load and outcomes of diabetes care in general practice. Diabet Med; 9, 275-278

British Heart Foundation (1997). Fact-file : Prevention of coronary heart disease in South Asians. London: British Heart Foundation

Dean A.G. , Dean J.A. , Coulombier D. , Brendel K.A. , Smith D.C. , Burton A.H. , Dicker R.C. , Sullivan K. , Fagan R.F. and Arner T.G. (1995). Epi Info, Version 6: A Word-Processing, Database and Statistics Program for Public Health on IBM-compatible Microcomputers . Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Gill P.S. , Dowell A. and Harris C.M. (1997). Effect of doctors' ethnicity and country of qualification on prescribing patterns in single handed general practices: linkage of information collected by questionnaire and from routine data. BMJ; 315, 1590-1594

Greenhalgh T. , Helman C. and Chowd-Hury A.M. (1998). Health beliefs and folk models of diabetes in British Bangladeshis: a qualitative study. BMJ; 316, 978-983

Hawthorne K. , Mello M. and Tomlin-Son S. (1993). Cultural and religious influences in diabetes care in Great Britain. Diabetic Med; 10, 8-12

Martin T.L. , Selby J.V. and Zhang D. (1995). Physician and patient prevention practices in NIDDM in a large urban managed-care organization. Diabetes Care; 18(8), 1124-1132

Nabarro J D N (1988). Diabetes in the United Kingdom: some facts and figures. Diabet Med; 5, 816-822

Sandwell Health Authority (1997). A new deal for health in Sandwell? The 9th annual report of the Director of Public Health Sandwell Health Authority

10.

Schatz P.E. (1988). An evaluation of the components of compliance in patients with diabetes. J Am Diet Assoc; 88(6), 708-712

11.

Simmons D. , Williams D R R and Powell M.J. (1989). Prevalence of diabetes in a predominantly Asian community: preliminary findings of the Coventry diabetes study. BMJ; 298, 18-21

12.

Uk Prospective Diabetes Study Group (1994). UK prospective diabetes study XII: differences between Asian, Afro-Caribbean and White Caucasian type II diabetic patients at diagnosis of diabetes. Diabet Med; 11, 670-677 Ward J. (1993). Type II diabetes care today. Pulse; (S3), 4

Do Asians with diabetes in Sandwell receive inferior primary care? A retrospective cohort study

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