Systematic review and meta‐analysis of patient race/ethnicity, socioeconomics, and quality for adult type 2 diabetes

Objective To review the evidence of the association between performance in eight indicators of diabetes care and a patient's race/ethnicity and socioeconomic characteristics. Data Source Studies of adult patients with type 2 diabetes in MEDLINE published between January 1, 2000, and December 31, 2018. Study Design Systematic review and meta‐analysis of regression‐based studies including race/ethnicity and income or education as explanatory variables. Meta‐analysis was used to quantify differences in performance associated with patient race/ethnicity or socioeconomic characteristics. The systematic review was used to identify potential mechanisms of disparities. Data Collection Two coauthors separately conducted screening, study exclusions, data extraction, and scoring of retained studies. Estimates in retained studies were extracted and, where applicable, were standardized and converted to odds ratios and standard errors. Principal Findings Performance in intermediate outcomes and process measures frequently exhibited differences by race/ethnicity even after adjustment for socioeconomic, lifestyle, and health factors. Meta‐analyses showed black patients had lower odds of HbA1c and blood pressure (BP) control (OR range: 0.67‐0.68, P