Impact of socioeconomic status and country of birth on health status and healthcare utilization among people with type 2 diabetes, Entred 2007.
Introduction - The impact of socioeconomic status and country of birth on the health status and healthcare utilization of people with type 2 diabetes in mainland France was studied using data from Entred 2007. Materials and Methods - 8,926 adults were randomly selected from the national health insurance databases, and their medical records were extracted; 4,277 individuals (3,894 with type 2 diabetes) completed a self-administered questionnaire; 2,485 physicians completed a medical questionnaire. Results - After adjusting for sex, age, duration of diabetes, and antidiabetic treatment, individuals with lower incomes were less likely to be followed by a private endocrinologist (OR = 0.7) but more likely to consult their general practitioner frequently (=12 visits/year, OR = 2.3) than those with higher incomes. They were not hospitalized more often (OR = 1.0). They were more likely to be covered by ALD (88%, OR = 1.5). They were just as likely to undergo at least 3 HbA1c tests (OR = 0.9) but less likely to undergo a microalbuminuria test (OR = 0.7), a fundus examination (OR = 0.4), or a monofilament test (OR = 0.7). They reported macrovascular complications (OR = 1.4) and podiatric complications (OR = 1.6) more frequently and were more likely to have chronic kidney disease (OR = 1.7). People born in the Maghreb reported ophthalmological complications more often than those born in France (OR = 1.6) but were less likely to have undergone a fundus examination (OR = 0.7). Similar results were found with other markers of socioeconomic status. Conclusion - People with diabetes from lower socioeconomic backgrounds are less likely to undergo screening for complications, despite having a long-term illness (ALD) and more frequent visits to a general practitioner, as well as a higher prevalence of these complications. However, the most vulnerable individuals likely did not participate; others may have received care not covered by health insurance (hospital visits, health screening centers, etc.), and socioeconomic status may have influenced patient reporting but not physician reporting. [author’s abstract] This poster is cited in the journal Diabetes & Metabolism, Supplement 1, Volume 36.
Annual Conference of the Francophone Diabetes Society (SFD)., Lille, 16-19 mars 2010
Author(s): Fosse S, Detournay B, Gautier A, Eschwege E, Paumier A, Fagot-campagna A
Publishing year: 2010
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