Guidelines accompanied by changes in reimbursement rules Effects on lipid-lowering drug prescribing

Objective - To study the medical situation and health-related quality of life (HRQOL) in foreign- and Swedish-born diabetic patients. Design - A cross-sectional, questionnaire survey of diabetic patients registered with primary health services, compared with the general Swedish population. Setting - Three community health centres in Stockholm County. Subjects - 62 foreign- and 351 Swedish-born subjects, aged 18-84 years. Age- and sex-matched controls from a standard population sample of 2500 individuals. Main outcome measures - Medical data extracted from the medical records. HRQOL assessed by the Swedish Health-Related Quality of Life Survey. Results - Differences were found for foreign- vs Swedish-born patients regarding diabetes duration, 7.9 vs 10.9 years, p&;lt;0.01; BMI, 31.9 vs 28.8, p&;lt;0.05; tablet treatment, 64.5% vs 46.4%, p&;lt;0.01; and diabetic complications, 37.5% vs 54.9%, p&;lt;0.05. HRQOL was decreased on nine of the 13 scales in foreign-born patients, and eight in Swedish-born. Foreign-born patients were also at larger risk to be among the third with worst health at seven of the scales. Conclusions - Foreign-born diabetic patients are at higher risk of experiencing bad health.