Evidence map›Paper›PMID 39079749›Full record

ArticleHealth services research2024

Evaluating equity in a national virtual care management intervention: Delivery and outcomes by race/ethnicity among Veterans with hypertension and diabetes.

Leah M Marcotte, Chelle L Wheat, Mayuree Rao, Edwin S Wong, Paul Hebert, Karin Nelson, Jorge Rojas, Eric J Gunnink, Ashok Reddy

Abstract read
In one paragraph

Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. From Integrated Care to Learning Systems.Healthcare (Basel, Switzerland) · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Leah M MarcotteDepartment of Medicine, University of Washington, Seattle, Washington, USA.ORCID 0000-0003-3130-3525
Chelle L WheatSeattle-Denver Center of Innovation for Veteran Centered and Value Driven Care, Seattle, Washington, USA.ORCID 0000-0002-2404-2681
Mayuree RaoDepartment of Medicine, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-0874-8238
Edwin S WongDepartment of Health Systems and Population Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-6079-686X
Paul HebertDepartment of Health Systems and Population Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-5886-7964
Karin NelsonDepartment of Medicine, University of Washington, Seattle, Washington, USA.ORCID 0000-0003-4901-6751
Jorge RojasSeattle-Denver Center of Innovation for Veteran Centered and Value Driven Care, Seattle, Washington, USA.
Eric J GunninkSeattle-Denver Center of Innovation for Veteran Centered and Value Driven Care, Seattle, Washington, USA.
Ashok ReddyDepartment of Medicine, University of Washington, Seattle, Washington, USA.ORCID 0000-0001-5238-629X

Funding

CATALyST: Consortium for Applied Training to Advance the Learning health system with Scholars/TraineesK12HS026369 · AHRQ · KAISER FOUNDATION RESEARCH INSTITUTE · PI LOZANO, PAULA, RALSTON, JAMES D. · 2018 to 2022
$3.5M
AHRQ HHS K12 HS026369AHRQ HHS K12HS026369VA Office of Primary Care
6 · The paper itself

Abstract

objectiveTo evaluate whether the Preventive Health Inventory (PHI)-a virtual care management intervention addressing hypertension and diabetes management implemented nationally in the Veterans Health Administration (VHA)-was delivered equitably among racial/ethnic groups and if existing inequities in hypertension and diabetes outcomes changed following PHI receipt. DATA SOURCES AND STUDY

settingWe used data from the VHA Corporate Data Warehouse among Veterans enrolled in primary care nationally from February 28, 2021 to March 31, 2022. STUDY

designWe used logistic regression to evaluate PHI receipt and hypertension and diabetes outcomes after PHI implementation among Veterans with hypertension and/or diabetes. We conducted unadjusted analyses and analyses adjusting for clinic fixed effects using dummy variables. DATA COLLECTION/EXTRACTION

methodsWe identified Veterans engaged in primary care with documented race/ethnicity and hypertension and/or diabetes diagnoses in all months during the study period. PRINCIPLE

findingsPrior to PHI, Non-Hispanic Black (NHB) (42.2%) and Hispanic (39.5%) Veterans were less likely to have controlled hypertension vs. Non-Hispanic White (NHW) Veterans (47.5%); NHB Veterans (32.9%) were more likely to have uncontrolled diabetes vs. NHW Veterans (25.1%). Among 1,805,658 Veterans, 5.7% NHW (N = 68,744), 5.6% NHB (N = 22,580), 10.2% Hispanic (N = 13,313), 6.2% Asian/Pacific Islander/Native Hawaiian (N = 1868), 5.1% American Indian/Native Alaskan (N = 744), and 5.6% multiple races or other race (N = 1647) Veterans received PHI. We found no significant racial inequities in PHI receipt in unadjusted and adjusted models. Hypertension and diabetes measures improved more in the intervention group compared with the group who did not receive the intervention. There were no new or worsened inequities after PHI, and in pre-/post-intervention analysis, among NHB Veterans, the inequity in uncontrolled diabetes improved by 1.9 percentage points (95% CI 0.2, 3.6).

conclusionsOur findings suggest the PHI intervention was equitably deployed across race/ethnicity groups without significantly impacting most existing inequities in diabetes and hypertension.

Indexed as

Diabetes MellitusEthnicityHypertensionRacial GroupsUnited States Department of Veterans AffairsVeteransAdultAgedFemaleHealthcare DisparitiesHumansMaleMiddle AgedPrimary Health CareSocioeconomic FactorsTelemedicinediabeteshealth equityhypertensionpopulation healthprimary caretelehealth

Identifiers

PMID39079749
PMCPMC11622288

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.