Adherence to diabetes care process indicators in migrants as compared to non-migrants with diabetes: a retrospective cohort study

Int J Public Health. 2019 May;64(4):595-601. doi: 10.1007/s00038-019-01220-5. Epub 2019 Mar 13.

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.

Keywords: Healthcare system; Matching analysis; Migrants; Quality indicator of diabetes care.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Medication Adherence / psychology*
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data*
  • Prevalence
  • Retrospective Studies
  • Self Care / psychology
  • Self Care / statistics & numerical data
  • Transients and Migrants / psychology*
  • Transients and Migrants / statistics & numerical data*