Evidence map›Paper›PMID 40730403›Full record

ArticleBMJ open2025

Neighbourhood deprivation and quality of comprehensive diabetes care: findings from a national retrospective cohort study of US Medicare Advantage enrollees.

Beau Blass, Hannah Mahoney, Jay B Lusk, Amy G Clark, Leonor Corsino, Bradley G Hammill

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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

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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

2 citing papers in PubMed.

  1. Article
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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

6 authors.

Beau BlassDuke University School of Medicine, Durham, North Carolina, USA beau.blass@duke.edu.ORCID http://orcid.org/0000-0002-2990-0817
Hannah MahoneyDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Jay B LuskDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Amy G ClarkDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Leonor CorsinoDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Bradley G HammillDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.ORCID http://orcid.org/0000-0002-0389-6434

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aims to assess the association between neighbourhood socioeconomic deprivation and outcomes reflecting comprehensive diabetes care (CDC).

designRetrospective cohort study

settingUS Medicare Advantage (MA) data, 2015-2020.

participantsNational sample of MA enrollees with diabetes. OUTCOME MEASURES: Primary outcomes included six indicators of CDC from the Healthcare Effectiveness Data and Information Set: haemoglobin (Hb) A1c (HbA1c) testing, HbA1c control (<8%), HbA1c poor control (>9%), blood pressure control (<140/90 mm Hg), receipt of eye exams and medical attention for nephropathy.

resultsThere were 827 227 enrolments included in the final analysis. After adjusting for demographic (age, sex, race/ethnicity and dual eligibility) and regional characteristics (rurality and primary care providers per capita), high neighbourhood deprivation was associated only with worse glycaemic control (for HbA1c>9%, risk ratio (RR) 1.04, 95% CI 1.02 to 1.07). This relationship was significant for white and Asian patients (RR 1.08, 95% CI 1.05 to 1.11 and RR 1.18, 95% CI 1.05 to 1.32, respectively); outcomes for black and Hispanic patients were worse overall but independent of neighbourhood deprivation (RR 1.00, 95% CI 0.96 to 1.05 and RR 0.98, 95% CI 0.94 to 1.03, respectively). In the fully adjusted model, neighbourhood deprivation was not associated with measures that directly reflect access to care, including the occurrence of HbA1c testing and receipt of eye exams (RR 0.99, 95% CI 0.94 to 1.04 and RR 1.03, 95% CI 1.00 to 1.05).

conclusionsAn increased risk of poor glycaemic control was observed for patients from areas of high neighbourhood deprivation, independent of individual socioeconomic status. Neighbourhood factors and their intersection with racial and ethnic disparities are important considerations for achieving equity in diabetes care.

Indexed as

Diabetes MellitusHealthcare DisparitiesMedicare Part CNeighborhood CharacteristicsQuality of Health CareResidence CharacteristicsAgedAged, 80 and overFemaleGlycated HemoglobinHumansMaleRetrospective StudiesSocioeconomic FactorsUnited StatesGlycated HemoglobinDIABETES & ENDOCRINOLOGYHealth EquityHealth ServicesPrimary Care

Identifiers

PMID40730403
PMCPMC12306466

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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.