Socio-economic disparities in the appropriateness of diabetes care in an Italian region: Findings of AEQUITAS study

AEQUITAS Study Group

Research output: Contribution to journalArticle

Abstract

Background: To evaluate socio-economic disparities in diabetes prevalence and care in Marches (a region of central Italy) in 2003-2010 through a cross-sectional study. Methods: The databases of 52 general practitioners were mined for people with diabetes (age ≥20 years). These data were linked with records from other regional administrative databases. Healthcare disparities, specifically potentially preventable hospitalizations (PPH) related to diabetes and its complications, were analysed using participants’ gender, age, and education data and the Italian Deprivation Index. Crude, age-specific and gender-specific diabetes prevalence was estimated for each year of observation. A time-trend analysis was performed. Admissions that might have been prevented according to Agency for Healthcare Research and Quality criteria were used to calculate the PPH rate for each level of social condition indicators. Rate ratios and 95% confidence intervals were estimated with a multiple Poisson regression model. Results: The search found 6,494 participants with diabetes mellitus aged ≥20 years. Disease prevalence ranged from 5.4% (2003) to 7.8% (2010), with a significant 0.31% positive trend. Those aged ≤44 years were at significantly higher risk of PPH than older people. A significant PPH excess was found among people living in socio-economically disadvantaged areas. Education and gender did not significantly affect PPH. Conclusions: People with diabetes seem to use primary care services appropriately irrespective of socio-economic status. Outpatient services are not equally distributed on the regional territory; this may increase disease severity and/ or the risk of diabetes complications and affect appropriateness of diabetes care.

Original languageEnglish
Pages (from-to)e12951-1-e12951-8
JournalEpidemiology Biostatistics and Public Health
Volume15
Issue number4
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Hospitalization
Economics
Diabetes Complications
Healthcare Disparities
Databases
Education
Health Services Research
Social Conditions
Vulnerable Populations
Ambulatory Care
General Practitioners
Italy
Primary Health Care
Diabetes Mellitus
Cross-Sectional Studies
Observation
Confidence Intervals

Keywords

  • Diabetes care appropriateness
  • Healthcare
  • Healthcare databases
  • Preventable hospitalization
  • Socio-economic disparities

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Community and Home Care
  • Public Health, Environmental and Occupational Health

Cite this

Socio-economic disparities in the appropriateness of diabetes care in an Italian region : Findings of AEQUITAS study. / AEQUITAS Study Group.

In: Epidemiology Biostatistics and Public Health, Vol. 15, No. 4, 01.01.2018, p. e12951-1-e12951-8.

Research output: Contribution to journalArticle

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abstract = "Background: To evaluate socio-economic disparities in diabetes prevalence and care in Marches (a region of central Italy) in 2003-2010 through a cross-sectional study. Methods: The databases of 52 general practitioners were mined for people with diabetes (age ≥20 years). These data were linked with records from other regional administrative databases. Healthcare disparities, specifically potentially preventable hospitalizations (PPH) related to diabetes and its complications, were analysed using participants’ gender, age, and education data and the Italian Deprivation Index. Crude, age-specific and gender-specific diabetes prevalence was estimated for each year of observation. A time-trend analysis was performed. Admissions that might have been prevented according to Agency for Healthcare Research and Quality criteria were used to calculate the PPH rate for each level of social condition indicators. Rate ratios and 95{\%} confidence intervals were estimated with a multiple Poisson regression model. Results: The search found 6,494 participants with diabetes mellitus aged ≥20 years. Disease prevalence ranged from 5.4{\%} (2003) to 7.8{\%} (2010), with a significant 0.31{\%} positive trend. Those aged ≤44 years were at significantly higher risk of PPH than older people. A significant PPH excess was found among people living in socio-economically disadvantaged areas. Education and gender did not significantly affect PPH. Conclusions: People with diabetes seem to use primary care services appropriately irrespective of socio-economic status. Outpatient services are not equally distributed on the regional territory; this may increase disease severity and/ or the risk of diabetes complications and affect appropriateness of diabetes care.",
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author = "{AEQUITAS Study Group} and Rosaria Gesuita and Francesca Piraccini and Edlira Skrami and Italo Paolini and Giuliano Sebastianelli and Carlo Stramenga and Dario Bartolucci and Alberico Marcobelli and Fabio Romagnoli and Giulia Silvestrini and Walter Ricciardi and Gianfranco Damiani and Flavia Carle",
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T1 - Socio-economic disparities in the appropriateness of diabetes care in an Italian region

T2 - Findings of AEQUITAS study

AU - AEQUITAS Study Group

AU - Gesuita, Rosaria

AU - Piraccini, Francesca

AU - Skrami, Edlira

AU - Paolini, Italo

AU - Sebastianelli, Giuliano

AU - Stramenga, Carlo

AU - Bartolucci, Dario

AU - Marcobelli, Alberico

AU - Romagnoli, Fabio

AU - Silvestrini, Giulia

AU - Ricciardi, Walter

AU - Damiani, Gianfranco

AU - Carle, Flavia

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: To evaluate socio-economic disparities in diabetes prevalence and care in Marches (a region of central Italy) in 2003-2010 through a cross-sectional study. Methods: The databases of 52 general practitioners were mined for people with diabetes (age ≥20 years). These data were linked with records from other regional administrative databases. Healthcare disparities, specifically potentially preventable hospitalizations (PPH) related to diabetes and its complications, were analysed using participants’ gender, age, and education data and the Italian Deprivation Index. Crude, age-specific and gender-specific diabetes prevalence was estimated for each year of observation. A time-trend analysis was performed. Admissions that might have been prevented according to Agency for Healthcare Research and Quality criteria were used to calculate the PPH rate for each level of social condition indicators. Rate ratios and 95% confidence intervals were estimated with a multiple Poisson regression model. Results: The search found 6,494 participants with diabetes mellitus aged ≥20 years. Disease prevalence ranged from 5.4% (2003) to 7.8% (2010), with a significant 0.31% positive trend. Those aged ≤44 years were at significantly higher risk of PPH than older people. A significant PPH excess was found among people living in socio-economically disadvantaged areas. Education and gender did not significantly affect PPH. Conclusions: People with diabetes seem to use primary care services appropriately irrespective of socio-economic status. Outpatient services are not equally distributed on the regional territory; this may increase disease severity and/ or the risk of diabetes complications and affect appropriateness of diabetes care.

AB - Background: To evaluate socio-economic disparities in diabetes prevalence and care in Marches (a region of central Italy) in 2003-2010 through a cross-sectional study. Methods: The databases of 52 general practitioners were mined for people with diabetes (age ≥20 years). These data were linked with records from other regional administrative databases. Healthcare disparities, specifically potentially preventable hospitalizations (PPH) related to diabetes and its complications, were analysed using participants’ gender, age, and education data and the Italian Deprivation Index. Crude, age-specific and gender-specific diabetes prevalence was estimated for each year of observation. A time-trend analysis was performed. Admissions that might have been prevented according to Agency for Healthcare Research and Quality criteria were used to calculate the PPH rate for each level of social condition indicators. Rate ratios and 95% confidence intervals were estimated with a multiple Poisson regression model. Results: The search found 6,494 participants with diabetes mellitus aged ≥20 years. Disease prevalence ranged from 5.4% (2003) to 7.8% (2010), with a significant 0.31% positive trend. Those aged ≤44 years were at significantly higher risk of PPH than older people. A significant PPH excess was found among people living in socio-economically disadvantaged areas. Education and gender did not significantly affect PPH. Conclusions: People with diabetes seem to use primary care services appropriately irrespective of socio-economic status. Outpatient services are not equally distributed on the regional territory; this may increase disease severity and/ or the risk of diabetes complications and affect appropriateness of diabetes care.

KW - Diabetes care appropriateness

KW - Healthcare

KW - Healthcare databases

KW - Preventable hospitalization

KW - Socio-economic disparities

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