Adherence to diabetes care process indicators in migrants as compared to non-migrants with diabetes: a retrospective cohort study

  • Giuseppe SeghieriEmail author
  • Chiara Seghieri
  • Laura Policardo
  • Elisa Gualdani
  • Paolo Francesconi
  • Fabio Voller
Original article



Prevalence rate of diabetes is high among migrants. Whether migrants are correctly addressed to a standard quality of care for diabetes and are properly followed up are the questions addressed by this retrospective cohort study.


Compliance to one or repeated Guideline Composite Indicator (GCI), a standard process indicator of care quality, was tested in migrants compared to non-migrant Italian residents with diabetes, living in Tuscany Region, Italy, in years 2011–2015. For those with no GCI, the analysis was repeated for the chance of being tested by at least one or more HbA1c measurements.


GCI compliance, in a single or repeated manner over time, was significantly less likely by about 15–20% among migrants (n = 3992) compared to non-migrants (n = 130,874), even after fully matching both cohorts. For those with no GCI, being tested by HbA1c was still significantly less likely among migrants.


Being addressed to a standard quality of care is impaired among migrant patients with diabetes living in Tuscany compared to non-migrants. Migrants, moreover, have a significantly lower probability of adhering to guidelines or to be tested by HbA1c measurement over time.


Migrants Quality indicator of diabetes care Matching analysis Healthcare system 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


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Copyright information

© Swiss School of Public Health (SSPH+) 2019

Authors and Affiliations

  • Giuseppe Seghieri
    • 1
    Email author
  • Chiara Seghieri
    • 2
  • Laura Policardo
    • 1
  • Elisa Gualdani
    • 1
  • Paolo Francesconi
    • 1
  • Fabio Voller
    • 1
  1. 1.Agenzia Regionale SanitàRegione ToscanaFlorenceItaly
  2. 2.Institute of Management and Department EMbeDSScuola Superiore Sant’AnnaPisaItaly

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