Abstract
Objectives
Prevalence rate of diabetes is high among migrants. Whether migrants are correctly addressed to a standard quality of care for diabetes and are properly followed up are the questions addressed by this retrospective cohort study.
Methods
Compliance to one or repeated Guideline Composite Indicator (GCI), a standard process indicator of care quality, was tested in migrants compared to non-migrant Italian residents with diabetes, living in Tuscany Region, Italy, in years 2011–2015. For those with no GCI, the analysis was repeated for the chance of being tested by at least one or more HbA1c measurements.
Results
GCI compliance, in a single or repeated manner over time, was significantly less likely by about 15–20% among migrants (n = 3992) compared to non-migrants (n = 130,874), even after fully matching both cohorts. For those with no GCI, being tested by HbA1c was still significantly less likely among migrants.
Conclusions
Being addressed to a standard quality of care is impaired among migrant patients with diabetes living in Tuscany compared to non-migrants. Migrants, moreover, have a significantly lower probability of adhering to guidelines or to be tested by HbA1c measurement over time.
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References
Agabiti N, Pirani M, Schifano P, Cesaroni G, Davoli M, Bisanti L et al (2009) Income level and chronic ambulatory care sensitive conditions in adults: a multicity population-based study in Italy. BMC Public Health 9:45
Ballotari P, Caroli S, Ferrari F, Romani G, Marina G, Chiarenza A, Manicardi V, Giorgi Rossi P (2015) Differences in diabetes prevalence and inequalities in disease management and glycaemic control by immigrant status: a population-based study (Italy). BMC Public Health 15:87
Barsanti S, Nuti S (2014) The equity lens in the health care performance evaluation system. Int J Health Plan Manag 29(3):e233–e246
Buja A, Gini R, Visca M, Damiani G, Federico B, Francesconi P, Donato D, Marini A, Donatini A, Brugaletta S, Baldo V, Bellentani M, Valore Project (2013) Prevalence of chronic diseases by immigrant status and disparities in chronic disease management in immigrants: a population-based cohort study, Valore Project. BMC Public Health 13:504
Cafagna G, Seghieri C (2017) Educational level and 30-day outcomes after hospitalization for acute myocardial infarction in Italy. BMC Health Serv Res 17:18
Cameron AC, Trivedi PK (2013) Regression analysis of count data. Cambridge University Press, Cambridge
Charlson ME, Pompei P, Ales KL et al (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383
Creatore MI, Moineddin R, Booth G, Manuel DH, DesMeules M, McDermott S, Glazier RH (2010) Age- and sex-related prevalence of diabetes mellitus among migrants to Ontario, Canada. CMAJ 182(8):781–789
Creatore MI, Booth GL, Manuel DG, Moineddin R, Glazier RH (2012) Diabetes screening among immigrants: a population-based urban cohort study. Diabetes Care 35(4):754–761
Fedeli U, Casotto V, Ferroni E, Saugo M, Targher G, Zoppini G (2015) Prevalence of diabetes across different immigrant groups in North-eastern Italy. Nutr Metab Cardiovasc Dis 25(10):924–930
Giannoni M, Casucci P, Ismail Z (2012) Diseguaglianze di salute ed equità nel ricorso ai servizi sanitari da parte dei cittadini stranieri nelle regioni italiane, Franco Angeli srl, Milano
Gini R, Francesconi P, Mazzaglia G et al (2013) Chronic disease prevalence from Italian administrative databases in the VALORE project: a validation through comparison of population estimates with general practice databases and national survey. BMC Public Health 13:15
Giorda C, Petrelli A, Gnavi R, Regional Board for Diabetes Care of Piemonte (2006) The impact of second-level specialized care on hospitalization in persons with diabetes: a multilevel population-based study. Diabet Med 23:377–383
Giorda C, Picariello R, Nada E et al (2012) The impact of adherence to screening guidelines and of diabetes clinics referral on morbidity and mortality in diabetes. PLoS ONE 7:e33839
Iacus SM, King G, Porro G (2011a) Causal inference without balance checking: coarsened exact matching. Political analysis. Copy at http://j.mp/2nRpUHQ
Iacus SM, King G, Porro G (2011b) Multivariate matching methods that are monotonic imbalance bounding. J Am Stat Assoc 106(493):345–361
Marchesini G, Bernardi D, Miccoli R, Rossi E, Vaccaro O, De Rosa M, Bonora E, Bruno G (2014) Under-treatment of migrants with diabetes in a universalistic healthcare system: the ARNO Observatory. Nutr Metab Cardiovasc Dis 24(4):393–399
Marzona I, Avanzini F, Tettamanti M, Vannini T, Fortino I, Bortolotti A, Merlino L, Genovese S, Roncaglioni MC (2018) Prevalence and management of diabetes in immigrants resident in the Lombardy Region: the importance of ethnicity and duration of stay. Acta Diabetol 55(4):355–362
Mather HM, Chaturvedi N, Fuller JH (1998) Mortality and morbidity from diabetes in South Asians and Europeans: 11-year follow-up of the Southall Diabetes Survey, London, UK. Diabet Med 15(1):53–59
Meeuwesen L, Harmsen JA, Bernsen RM, Bruijnzeels MA (2006) Do Dutch doctors communicate differently with immigrant patients than with Dutch patients? Soc Sci Med 63:2407e17
Montesi L, Caletti MT, Marchesini G (2016) Diabetes in migrants and ethnic minorities in a changing world. World J Diabetes 7(3):34–44
Norredam M, Nielsen SS, Krasnik A (2010) Migrants’ utilization of somatic healthcare services in Europe—a systematic review. Eur J Public Health 20:555e63
Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M (2013) Migration and health in an increasingly diverse Europe. Lancet 381(9873):1235–1245
Seghieri C, Policardo L, Francesconi P, Seghieri G (2016) Gender differences in the relationship between diabetes process of care indicators and cardiovascular outcomes. Eur J Public Health 26(2):219–224
Srivastava R, Bishu KG, Walker RJ, Williams JS, Egede LE (2018) Quality of diabetes care among recent immigrants to the USA. J Racial Ethn Health Disparities. https://doi.org/10.1007/s40615-018-00542-z (Epub ahead of print)
Testa R, Bonfigli AR, Genovese S, Ceriello A (2016) Focus on migrants with type 2 diabetes mellitus in European Countries. Intern Emerg Med 11(3):319–326
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Seghieri, G., Seghieri, C., Policardo, L. et al. Adherence to diabetes care process indicators in migrants as compared to non-migrants with diabetes: a retrospective cohort study. Int J Public Health 64, 595–601 (2019). https://doi.org/10.1007/s00038-019-01220-5
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DOI: https://doi.org/10.1007/s00038-019-01220-5