Aims. To evaluate whether differences exist in the quality of diabetes care delivered to the Arab and Jewish populations in Jerusalem. Methods. A cross-sectional study was conducted in West Jerusalem's 4 major hospitals. Participants were patients with type 2 diabetes mellitus, 45 to 75 years of age, who were insured by Israel's largest health maintenance organization (HMO) and admitted to an emergency room (ER) between May and June 2004 for any medical cause. Hospital files were reviewed, patients were interviewed, and computerized data were retrieved from the HMO's database. Results. Arab patients received less nutritional counseling (odds ratio [OR] = 0.46; 95% CI = 0.24-0.85; P = .013), fewer recommendations about and less support in performing physical activities (OR = 0.42; 95% CI = 0.24-0.74; P = .003), and less guidance in performing self foot examinations (OR = 0.55; 95% CI = 0.32-0.96; P = .035). Conclusions. Arab patients in Jerusalem receive lower quality diabetes care compared with Jewish residents. (Am J Med Qual 2008;23:60-65)
State of Israel—Ministry of Health.Health in Israel— Selected Data. Jerusalem: Ministry of Health; 2001:132.
2.
Abdul-Ghani MA, Sabbah M., Muati B., et al. High frequency of pre-diabetes, undiagnosed diabetes and metabolic syndrome among overweight Arabs in Israel. Isr Med Assoc J. 2005;7:143-147.
3.
Cohen AD, Gefen K., Ozer A., et al. Diabetes control in the Bedouin population in southern Israel . Med Sci Monit. 2005;11(8):CR376-CR380.
4.
American Diabetes Association.Standards of medical care in diabetes. Diabetes Care . 2004; 27(suppl 1):S15-S31.
5.
McGlyn E. , Asch S., Adams J., et al. The quality of health delivered to adults in the United States. N Engl J Med.2003;348:2635-2645.
6.
Garfinkel SA , Bonito AJ, McLeroy KRSocioeconomic factors and Medicare supplemental health insurance. Health Care Financ Rev.1987;9(1):21-30.
7.
Munoz CASocioeconomic determinants of health insurance status among Puerto Ricans . PR Health Sci J. 1988;7(1):27-30.
8.
Hippisley-Cox J., O'Hanlon S., Coupland C.Association of deprivation, ethnicity, and sex with quality indicators for diabetes: population based survey of 53,000 patients in primary care. BMJ.2004;329:1267-1269.
9.
Kark JD, Gordon ES, Haklai H.Coronary heart disease mortality among Arab and Jewish residents of Jerusalem . Lancet. 2000;356:1410-1411.
10.
Henricson K. , Stenberg P., Rametsteiner G., et al. Socioeconomic factors, morbidity and drug utilization—an ecological study. Pharmacoepidemiol Drug Saf.1998;7:261-267.
11.
Karter AJ, Ferrara A., Darbinian JA, Ackerson LM, Selby JVLanguage and financial barriers in a managed care population with diabetes . Diabetes Care. 2000;23:477-483.
12.
Solis JM, Marks G., Garcia M., Shelton D.Acculturation, access to care, and use of preventive services by Hispanics: findings from HHANES 1982-84. Am J Public Health.1990; 80(suppl 1):1-9.
13.
Pochhacker F.When nurses double as interpreters: a study of Spanish-speaking patients in a US primary care setting. EthnHealth. 2000;5:113-119.
14.
Neumark YD, Rahav G., Jaffe DHSocio-economic status and binge drinking in Israel. Drug Alcohol Depend.2003;69:15-21.
15.
Keinan-Boker L., Noyman N., Chinich A., Green MS, Nitzan-Kaluski D.Overweight and obesity prevalence in Israel: findings of the first national health and nutrition survey (MABAT). Isr Med Assoc J. 2005;7:219-223.
16.
Abdul-Ghani MA, Kher J., Abbas N., Najami T.Association of high body mass index with low age of disease onset among Arab women with type 2 diabetes in a primary care clinic. Isr Med Assoc J. 2005;7:360-363.
17.
Koopman RJ, Mainous AG III, Diaz VA, Geesey MEChanges in age at diagnosis of type 2 diabetes mellitus in the United States, 1988 to 2000. Ann Fam Med.2005;3:60-63.
18.
Rosenbloom AL, Young RS, Joe JR, Winter WEEmerging epidemic of type 2 diabetes in youth . Diabetes Care. 1999; 22:345-354.
19.
Hillier TA, Pedula KLCharacteristics of an adult population with newly diagnosed type 2 diabetes: the relation of obesity and age of onset. Diabetes Care. 2001;24:1522-1527.
20.
Hanson RL, Elston RC, Pettitt DJ, Bennett PH, Knowler WCSegregation analysis of non-insulin dependent diabetes mellitus in Pima Indians: evidence for a major-gene effect. Am J Hum Genet.1995;57:160-170.
21.
Lillioja S. , Bogardus C.Obesity and insulin resistance: lessons learned from the Pima Indians. Diabetes Metab Rev . 1988;4:517-540.
22.
Roos NP, Mustard CAVariation in health and health care use by socioeconomic status in Winnipeg, Canada: does the system work well? Yes and no. Milbank Q.1997;75:89-111.
23.
Roos LL, Walld R., Uhanova J., Bond R.Physician visits, hospitalizations, and socioeconomic status: ambulatory care sensitive conditions in a Canadian setting. Health Serv Res.2005;40:1167-1185.
24.
Weissman JS , Gatsonis C., Epstein AMRates of avoidable hospitalization by insurance status in Massachusetts and Maryland. JAMA.1992;268:2388-2394.
25.
Billings J. , Zeitel L., Lukomnik J., et al. Impact of socioeconomic status on hospital use in New York City. Health Aff (Millwood) . 1993;12(1):162-173.
