Health Inequalities Among Elderly Type 2 Diabetes Mellitus Patients in Japan

研究成果: ジャーナルへの寄稿記事

抄録

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).

元の言語英語
ジャーナルPopulation Health Management
DOI
出版物ステータス印刷前のE-pub - 10 29 2019

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Type 2 Diabetes Mellitus
Japan
Hospitalization
Social Class
Medication Adherence
Health
Diabetes Complications
Hypoglycemic Agents
Unsafe Sex
Oral Health
Survival Analysis
Comorbidity
Logistic Models
Odds Ratio

これを引用

@article{98f09be6fefd495db3430e0d4cec4750,
title = "Health Inequalities Among Elderly Type 2 Diabetes Mellitus Patients in Japan",
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).",
author = "Peng Jiang and Akira Babazono and Takako Fujita",
year = "2019",
month = "10",
day = "29",
doi = "10.1089/pop.2019.0141",
language = "English",
journal = "Population Health Management",
issn = "1942-7891",
publisher = "Mary Ann Liebert Inc.",

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TY - JOUR

T1 - Health Inequalities Among Elderly Type 2 Diabetes Mellitus Patients in Japan

AU - Jiang, Peng

AU - Babazono, Akira

AU - Fujita, Takako

PY - 2019/10/29

Y1 - 2019/10/29

N2 - 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).

AB - 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).

U2 - 10.1089/pop.2019.0141

DO - 10.1089/pop.2019.0141

M3 - Article

C2 - 31657660

JO - Population Health Management

JF - Population Health Management

SN - 1942-7891

ER -