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Influence of Language and Physician-Patient Racial Concordance on Diabetes Control: An Analysis of Consultations in
Miguel Ángel Fernández-Ortega1, Lilia V Castro-Porras2, Gustavo A Olaiz-Fernández2
1Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Universidad Nacional Autónoma de México, 12 Ciudad Universitaria, Edificio CIPPS-Sótano y Piso 2, Cto. Centro Cultural S/N, Coyoacán, 04510, Mexico City, Mexico. miguelaf@comunidad.unam.mx.
Objective:
To compare the proportion of patients with diabetes under metabolic control in three health clinics attended by Mexican doctors vs. non-Mexican doctors.
Methods:
Longitudinal analytical study of three clinics in California in which data from 8979 consultations in 2023 were analyzed. Control of patients with diabetes was evaluated based on the nationality of the physician (Mexican/non-Mexican), the type of consultation (first-time or follow-up), and referrals to the Nephrology department. Frequency analysis and chi-square were performed to estimate the risk of the selected outcomes (uncontrolled diabetes or referral to the nephrology service), and the Hosmer and Lemeshow goodness-of-fit test was applied.
Results:
Better control was observed in consultations of patients with diabetes seen by Mexican physicians compared to non-Mexican physicians OR = 1.62 [1.42, 1.84]. Likewise, the percentage of patients referred to Nephrology was almost triple by non-Mexican physicians compared to Mexican physicians OR = 2.69 [1.84, 3.92].
Conclusions:
The cultural and linguistic concordance between Mexican physicians and Spanish-speaking patients may contribute to improved diabetes control and could lead to greater engagement with primary care services among newly diagnosed diabetes patients.
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