Individual and community-level income and the risk of diabetes rehospitalization among women and men: a Canadian population-based cohort study
| العنوان: | Individual and community-level income and the risk of diabetes rehospitalization among women and men: a Canadian population-based cohort study |
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| المؤلفون: | Neeru Gupta, Dan L. Crouse, Adele Balram |
| المصدر: | BMC Public Health BMC Public Health, Vol 20, Iss 1, Pp 1-9 (2020) |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Canada, Population, Population health, Preventable hospitalization, Low income, Patient Readmission, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Diabetes mellitus, Residence Characteristics, Risk Factors, Epidemiology, medicine, Humans, 030212 general & internal medicine, education, Socioeconomic status, Aged, Hospital admissions, education.field_of_study, Family Characteristics, 030505 public health, business.industry, Public health, lcsh:Public aspects of medicine, 1. No poverty, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Odds ratio, Health Status Disparities, Middle Aged, 3. Good health, Gender and ethnic differences, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Income, Household income, Female, 0305 other medical science, business, Rehospitalization, Demography, Cohort study, Research Article |
| الوصف: | Background Marked disparities by socioeconomic status in the risk of potentially avoidable hospitalization for chronic illnesses have been observed in many contexts, including those with universal health coverage. Less well known is how gender mediates such differences. We conducted a population-based cohort study to describe associations between household and community-level income and rehospitalizations for types 1 and 2 diabetes mellitus among Canadian women and men. Methods Our cohorts were drawn from respondents to the 2006 mandatory long-form census linked longitudinally to 3 years of nationally standardized hospital records. We included adults 30–69 years hospitalized with diabetes at least once during the study period. We used logistic regressions to estimate odds ratios for 12-month diabetes rehospitalization associated with indicators of household and community-level income, with separate models by gender, and controlling for a range of other sociodemographic characteristics. Since diabetes may not always be recognized as the main reason for hospitalization, we accounted for disease progression through consideration of admissions where diabetes was previously identified as a secondary diagnosis. Results Among persons hospitalized at least once with diabetes (n = 41,290), 1.5% were readmitted within 12 months where the initial admission had diabetes as the primary diagnosis, and 1.8% were readmitted where the initial admission had diabetes as a secondary diagnosis. For men, being in the lowest household income quintile was associated with higher odds of rehospitalization in cases where the initial admission listed diabetes as either the primary diagnosis (OR = 2.21; 95% CI = 1.38–3.51) or a secondary diagnosis (OR = 1.51; 95% CI = 1.02–2.24). For women, we found no association with income and rehospitalization, but having less than university education was associated with higher odds of rehospitalization where diabetes was a secondary diagnosis of the initial admission (OR = 1.88; 95% CI = 1.21–2.92). We also found positive, but insignificant associations between community-level poverty and odds of rehospitalization. Conclusions Universal health coverage remains insufficient to eliminate socioeconomic inequalities in preventable diabetes-related hospitalizations, as illustrated in this Canadian context. Decision-makers should tread cautiously with gender-blind poverty reduction actions aiming to enhance population health that may inadequately respond to the different needs of disadvantaged women and men with chronic illness. |
| تدمد: | 1471-2458 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a63e6998956cc25d39ca5c719e80e56c https://pubmed.ncbi.nlm.nih.gov/31937292 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....a63e6998956cc25d39ca5c719e80e56c |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14712458 |
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