Increasing access to health care providers through medical home model may abolish racial disparity in diabetes care: evidence from a cross-sectional study

J Natl Med Assoc. 2011 Mar;103(3):250-6. doi: 10.1016/s0027-9684(15)30293-5.


Objectives: We hypothesized that the medical home model is an effective intervention to decreasing health care disparities in minority patients with diabetes.

Setting: Set in a community-based health initiative in Jacksonville, Florida, the study's mission was to support and enhance the primary care infrastructure in an effort to improve quality of care and increase access while reducing costs.

Intervention: We preformed a retrospective analysis of outcomes on 457 patients identified by registry specialists and enrolled in the diabetes rapid access program (DRAP). Data were obtained on 457 diabetic patients enrolled in the 6 clinic centers of the program between June 1, 2006, and December 31, 2009.

Main outcome measures: Improvements in hemoglobin A1c and proportion of patients with hemoglobin A1c of more than 8% according to gender, race, and clinic location.

Results: The average hemoglobin A1c at the beginning of the study was 8.2% (+/-2.3), and decreased significantly by an average of 0.5% (p<.005). The mean improvement in hemoglobin A1c did not differ significantly by clinic location, race, or gender. Both African American and Caucasian patients as well as men and women with a hemoglobin A1c of at least 8% showed a significant improvement in their A1c after the intervention (p<.005).

Conclusions: The DRAP medical home model presents an opportunity to decrease disparities in care and improve diabetes care.

MeSH terms

  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / ethnology*
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Female
  • Florida
  • Glycated Hemoglobin / analysis
  • Health Services Accessibility*
  • Healthcare Disparities*
  • Humans
  • Male
  • Middle Aged
  • Patient-Centered Care / standards*
  • Prejudice*
  • Prospective Studies
  • Statistics, Nonparametric
  • Urban Population


  • Glycated Hemoglobin A