The impact of socio-economic disadvantage on rates of hospital separations for diabetes-related foot disease in Victoria, Australia

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• 作者：Shan M Bergin (1)
  Caroline A Brand (2)
  Peter G Colman (3)
  Don A Campbell (4)
  
• 刊名：Journal of Foot and Ankle Research
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：4
• 期：1
• 全文大小：224KB
• 参考文献：1. Mete C, Cioffi JP, Lichtveld M: Are public health services available where they are most needed? An examination of local health department services. / J Public Health Manag Pr 2003, 9:214鈥?23.
  2. Singh-Manoux A, Adler NE, Marmot MG: Subjective social status: its determinants and it association with measures of ill-health in the Whitehall II study. / Soc Sci Med 2003, 56:1321鈥?333. CrossRef
  3. van Doorslaer E, Koolman X: Explaining the differences in income-related health inequalities across European countries. / Health Econ 2004, 13:609鈥?28. CrossRef
  4. Makinen M, Waters H, Rauch M, Almagambetova N, Bitran R, Gilson L, McIntyre D, Pannarunothai S, Prieto AL, Ubilla G, Ram S: Inequalities in health care use and expenditure: empirical data from eight developing countries and countries in transition. / Bull World Health Organ 2000, 78:55鈥?5.
  5. Walker B, Figgs LW, Zahm SH: Differences in cancer incidence, mortality and survival between African Americans and whites. / Environ Health Perspect 1995,103(Suppl 8):S275-S281. CrossRef
  6. Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, Kunst AE, European Union Working Group on Socioeconomic Inequalities in Health: Socioeconomic inequalities in health in 22 European countries. / New Eng J Med 2008, 358:2468鈥?481. CrossRef
  7. Thomas DP, Condon JR, Anderson IP, Li SQ, Halpin S, Cunningham J, Guthridge SL: Long-term trends in indigenous deaths from chronic diseases in the Northern Territory: a foot on the brake, a foot on the accelerator. / Med J Aust 2006, 185:145鈥?49.
  8. Cunningham J, Rumbold AR, Zhang X, Condon JR: Incidence, aetiology and outcomes of cancer in indigenous peoples in Australia. / Lancet Oncol 2008, 9:585鈥?95. CrossRef
  9. Lawrence SM, Wraight PR, Campbell DA, Colman PG: Assessment and management of acute diabetes related foot complications: room for improvement. / Inter Med J 2004, 34:229鈥?33. CrossRef
  10. Australian Institute of Health and Welfare: / Diabetes hospitalisations in Australia, 2003鈥?4. Canberra: Australian Institute of Health and Welfare; 2006.
  11. How Australia takes a census [http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2903.02006]
  12. Socio-economic Indexes for Areas - Technical Paper [http://www.abs.gov.au/websitedbs/D3310114.nsf/home/Seifa_entry_page]
  13. Australian Standard Geographical Classification (ASGC) [http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/1216.02004?OpenDocument]
  14. Australia Post Postcode Datafile [http://www.austpost.com.au/]
  15. Department of Human Services, Victoria. Victorian Admitted Episodes Database User Manual 18 ^th Ed. (2008/09) [http://www.health.vic.gov.au/hdss/vaed/index.htm]
  16. The Australian Bureau of Statistics. 2006 census data by location [http://www.abs.gov.au/]
  17. Weng C, Coppini DV, S枚nksen PH: Geographic and social factors are related to increased morbidity and mortality rates in diabetic patients. / Diabet Med 2000, 17:612鈥?17. CrossRef
  18. Bihan H, Laurent S, Sass C, Nguyen G, Huot C, Moulin JJ, Guegen R, Le Toumelin P, Le Cl茅siau H, La Rosa E, Reach G, Cohen R: Association among individual deprivation, glycaemic control, and diabetes complications: The EPICES score. / Diabetes Care 2005, 28:2680鈥?685. CrossRef
  19. Tseng CW, Tierney EF, Gerzoff RB, Dudley RA, Waitzfelder B, Ackermann RT, Karter AJ, Piette J, Crosson JC, Ngo-Metzger Q, Chung R, Mangione CM: Race/ethnicity and economic differences in cost-related medication underuse among insured adults with diabetes: the Translating Research into Action for Diabetes Study. / Diabetes Care 2008, 31:261鈥?66. CrossRef
  20. Kirk JK, D'Agostino RB Jr, Bell RA, Passmore LV, Bonds DE, Karter AJ, Narayan KM: Disparities in HbA1c levels between African-Americans and non-Hispanic white adults with diabetes: a meta-analysis. / Diabetes Care 2006, 29:2130鈥?136. CrossRef
  21. Department of Human Services, Victoria. Audits of Hospital Admitted Patient Data 2005鈥?9 [http://www.health.vic.gov.au/hdss/vaed/audit/index.htm]
  
• 作者单位：Shan M Bergin (1)
  Caroline A Brand (2)
  Peter G Colman (3)
  Don A Campbell (4)
  
  1. Podiatry Department, Dandenong Hospital, Melbourne, Victoria, 3172, Australia
  2. Clinical Epidemiology and Health Service Evaluation Unit, Royal Melbourne Hospital, Melbourne, Victoria, 3052, Australia
  3. Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, Victoria, 3052, Australia
  4. Department of General Medicine, Monash University, Melbourne, Victoria, 3169, Australia
  

文摘

Background Information describing variation in health outcomes for individuals with diabetes related foot disease, across socioeconomic strata is lacking. The aim of this study was to investigate variation in rates of hospital separations for diabetes related foot disease and the relationship with levels of social advantage and disadvantage. Methods Using the Index of Relative Socioeconomic Disadvantage (IRSD) each local government area (LGA) across Victoria was ranked from most to least disadvantaged. Those LGAs ranked at the lowest end of the scale and therefore at greater disadvantage (Group D) were compared with those at the highest end of the scale (Group A), in terms of total and per capita hospital separations for peripheral neuropathy, peripheral vascular disease, foot ulceration, cellulitis and osteomyelitis and amputation. Hospital separations data were compiled from the Victorian Admitted Episodes Database. Results Total and per capita separations were 2,268 (75.3/1,000 with diabetes) and 2,734 (62.3/1,000 with diabetes) for Group D and Group A respectively. Most notable variation was for foot ulceration (Group D, 18.1/1,000 versus Group A, 12.7/1,000, rate ratio 1.4, 95% CI 1.3, 1.6) and below knee amputation (Group D 7.4/1,000 versus Group A 4.1/1,000, rate ratio 1.8, 95% CI 1.5, 2.2). Males recorded a greater overall number of hospital separations across both socioeconomic strata with 66.2% of all separations for Group D and 81.0% of all separations for Group A recorded by males. However, when comparing mean age, males from Group D tended to be younger compared with males from Group A (mean age; 53.0 years versus 68.7 years). Conclusion Variation appears to exist for hospital separations for diabetes related foot disease across socioeconomic strata. Specific strategies should be incorporated into health policy and planning to combat disparities between health outcomes and social status.