BMJ  2004;329:1267-1269 (27 November), doi:10.1136/bmj.38279.588125.7C (published 17 November 2004)

Primary care

Association of deprivation, ethnicity, and sex with quality indicators for diabetes: population based survey of 53 000 patients in primary care

¹ Division of Primary Care, Tower Building, University Park, Nottingham NG2 7RD, ² The Surgery, Wonersh, Guildford GU5 0PE

Objectives To determine the effect of deprivation and ethnicity on the achievement of quality indicators for patients with diabetes and the extent of any inequalities between the sexes.

Design Population based cross sectional survey using electronic general practice records.

Setting 237 UK practices contributing to the QRESEARCH database.

Participants 54 180 patients with diabetes, derived from a population of 1.8 million patients.

Main outcome measures Adjusted odds ratios for 18 indicators for diabetes from the new general medical services contract for UK general practitioners and comparisons between patients from the most deprived and most affluent fifths (areas of high and low ethnicity) and between men and women.

Results The prevalence of diabetes was 3.0%, and there was a large variation between practices in achievement of indicators. Compared with patients from affluent areas, those from deprived areas were less likely to have body mass index and smoking status recorded. They were also less likely to have records for HbA_1c concentration; an HbA_1c value < 7.5% or < 10%; retinal screening; blood pressure; testing for neuropathy or microalbuminuria, or flu vaccination. Compared with patients from areas of low ethnicity those from areas of high ethnicity were less likely to have many measures recorded. Women were significantly less likely to have records for body mass index; pulses; blood pressure values below 145/85 mm Hg; testing for microalbuminuria; serum cholesterol concentration; serum cholesterol values < 5 mmol/l; and angiotensin converting enzyme inhibitors given in the presence of proteinuria or microalbuminuria.

Conclusions Practices in areas of high deprivation and high ethnicity will have to work harder to achieve the quality indicators for diabetes, and it is possible that those practices that most need the resources are the ones least likely to get them.

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Rapid Responses:

Read all Rapid Responses

What is ethnicity?

Chris J Burns-Cox
bmj.com, 26 Nov 2004 [Full text]

The real issue is prevalence...

David J Shepherd
bmj.com, 29 Nov 2004 [Full text]

Ethnicity, Ethnic Group, Population Diversity

Mark RD Johnson
bmj.com, 29 Nov 2004 [Full text]

Female patients with diabetes face higher risk than males if low educated

Peter M. Nilsson
bmj.com, 29 Nov 2004 [Full text]

Interesting but not surprising

Hendrik J Beerstecher
bmj.com, 3 Dec 2004 [Full text]

New Contract Prelevance Factor...Future Cause Of Inequalities In Health?

john s ashcroft
bmj.com, 6 Jan 2005 [Full text]