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Health Inequalities Among Elderly Type 2 Diabetes Mellitus Patients in Japan.
- Source :
-
Population Health Management . Jun2020, Vol. 23 Issue 3, p264-270. 7p. 1 Chart, 4 Graphs. - Publication Year :
- 2020
-
Abstract
- The influence of socioeconomic status (SES) on health inequalities has received much attention worldwide. This study examined the effect of SES on the following older type 2 diabetes mellitus patient health outcomes: oral hypoglycemic agent (OHA) medication adherence (proportion of days covered, PDC), risk of hospitalization for diabetic macrovascular complications, and in-hospital death. A retrospective cohort design using 2013–2016 claims data was used. Subjects were 58,349 diabetes patients aged >74 years in 2013. Age, sex, residential area, and comorbidities were controlled for. Logistic regression was conducted to assess the effects of income on PDC; survival analysis was used to assess the effects on hospitalization and in-hospital death. Regressions were conducted separately by sex. Compared with the lowest income group, adjusted PDC odds ratios for medium- and high-income males, respectively, were 1.35 (95% CI: 1.27–1.43) and 1.41 (95% CI: 1.30–1.54); females: 1.17 (95% CI: 1.11–1.23) and 1.24 (95% CI: 1.13–1.35). Adjusted hazard ratios (AHRs) for male hospitalization were 0.88 (95% CI: 0.80–0.96) and 0.88 (95% CI: 0.79–0.99); females: 1.00 (95% CI: 0.93–1.07) and 0.95 (95% CI: 0.83–1.08). AHRs for male in-hospital death were 0.83 (95% CI: 0.75–0.91) and 0.62 (95% CI: 0.54–0.70); females: 0.94 (95% CI: 0.87–1.02) and 0.77 (95% CI: 0.65–0.92). Results revealed sex-specific health inequalities among older Japanese diabetes patients. Subjects with worse SES had significantly poorer OHA medication adherence (both sexes), higher hospitalization risk for diabetes complications (males), and higher in-hospital death risk (both sexes). [ABSTRACT FROM AUTHOR]
- Subjects :
- *TYPE 2 diabetes complications
*CONFIDENCE intervals
*STATISTICAL correlation
*DRUGS
*HEALTH services accessibility
*HEALTH status indicators
*HOSPITAL care
*HYPOGLYCEMIC agents
*LONGITUDINAL method
*EVALUATION of medical care
*MORTALITY
*MULTIVARIATE analysis
*TYPE 2 diabetes
*PATIENT compliance
*QUESTIONNAIRES
*RISK assessment
*SEX distribution
*SURVIVAL analysis (Biometry)
*MATHEMATICAL variables
*LOGISTIC regression analysis
*SOCIOECONOMIC factors
*STATISTICAL significance
*RETROSPECTIVE studies
*DATA analysis software
*DESCRIPTIVE statistics
*ODDS ratio
*OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 19427891
- Volume :
- 23
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Population Health Management
- Publication Type :
- Academic Journal
- Accession number :
- 143615270
- Full Text :
- https://doi.org/10.1089/pop.2019.0141