Disparities in Diabetes Care Quality by English Language Preference in Community Health Centers

Health Serv Res. 2018 Feb;53(1):509-531. doi: 10.1111/1475-6773.12590. Epub 2016 Oct 21.

Abstract

Objective: To conduct a parallel analysis of disparities in diabetes care quality among Latino and Asian community health center (CHC) patients by English language preference.

Study setting/data collection: Clinical outcomes (2011) and patient survey data (2012) for Type 2 diabetes adults from 14 CHCs (n = 1,053).

Study design: We estimated separate regression models for Latino and Asian patients by English language preference for Clinician & Group-Consumer Assessment of Healthcare Providers and System, Patient Assessment of Chronic Illness Care, hemoglobin A1c, and self-reported hypoglycemic events. We used the Blinder-Oaxaca decomposition method to parse out observed and unobserved differences in outcomes between English versus non-English language groups.

Principal findings: After adjusting for socioeconomic and health characteristics, disparities in patient experiences by English language preference were found only among Asian patients. Unobserved factors largely accounted for linguistic disparities for most patient experience measures. There were no significant differences in glycemic control by language for either Latino or Asian patients.

Conclusions: Given the importance of patient retention in CHCs, our findings indicate opportunities to improve CHC patients' experiences of care and to reduce disparities in patient experience by English preference for Asian diabetes patients.

Keywords: Diabetes; community health centers; limited English proficiency; racial-ethnic disparities.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Asian / psychology
  • Community Health Centers / statistics & numerical data*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glycated Hemoglobin
  • Health Status
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino / psychology
  • Humans
  • Language*
  • Male
  • Patient Satisfaction / ethnology
  • Quality of Health Care / statistics & numerical data*
  • Sex Factors
  • Socioeconomic Factors

Substances

  • Glycated Hemoglobin A