Socio-economic deprivation and healthcare service use of young people with type 1 and type 2 diabetes.

Autor:	Wijayaratna S; Diabetologist, Auckland Diabetes Centre, Greenlane Clinical Centre, Auckland District Health Board, New Zealand., Lee A; Biostatistician, Department of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand., Jo E; Honorary lecturer, Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand; Manager, Analytics and Intelligence, Health Workforce Directorate, Ministry of Health, New Zealand., Young Park H; Medical student, Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand., Cundy T; Professor, Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand., Bagg W; Professor and deputy dean, Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.
Jazyk:	angličtina
Zdroj:	The New Zealand medical journal [N Z Med J] 2022 Nov 11; Vol. 135 (1565), pp. 74-82. Date of Electronic Publication: 2022 Nov 11.
DOI:	10.26635/6965.5830
Abstrakt:	Aim: Lower socio-economic status (SES) is linked to greater morbidity in people with young-onset type 2 (T2D) and type 1 diabetes (T1D). We assessed healthcare utilisation from this population and the impact of SES. Methods: Retrospective analysis of 1,350 people with T2D and 731 with T1D diagnosed between 15-30 years of age referred to secondary diabetes services in Auckland, New Zealand. Primary care visits, referral to/attendance at diabetes clinics, and hospital admissions were recorded; their relationship to a validated national index of deprivation (NZDep) was assessed. Results: The proportion with primary care attendance was similar in both groups with no significant variation with NZDep. For T2D, NZDep was a predictor of delayed referral (≧1-year post-diagnosis) to diabetes services, following adjustment for age and HbA1c in the year of diagnosis (OR 1.15 for every decile increase in NZDep, 95% CI 1.07-1.24, p=0.0003). The median number of appointments offered over a 2-year period was greater for T1D (2.0 (IQR 0, 7) vs (0 (IQR 0, 2), p<0.001); non-attendance increased with NZDep for T2D (p=0.016). The proportion with hospital admissions was similar in both groups and increased with NZDep (T1D p<0.001, T2D p=0.015). Conclusion: SES impacts several measures of healthcare utilisation. Current healthcare models are inadequately servicing people with young-onset T2D. Competing Interests: Nil. (© PMA.)
Databáze:	MEDLINE
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