NDLI: Type 2 diabetes care in North Karelia Finland: do area-level socio-economic factors affect processes and outcomes?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sikiö, Maija Tykkyläinen, Markku Tirkkonen, Hilkka Kekäläinen, Päivi Dunbar, James Laatikainen, Tiina
Spatial Coverage	Finland
Description	Author Affiliation: Sikiö M ( Department of Geographical and Historical Studies, University of Eastern Finland, Joensuu, Finland. Electronic address: maija.sikio@uef.fi.); Tykkyläinen M ( Department of Geographical and Historical Studies, University of Eastern Finland, Joensuu, Finland.); Tirkkonen H ( Health Centre of Outokumpu, Outokumpu, Finland.); Kekäläinen P ( Department of Internal Medicine, Hospital District of North Karelia, Joensuu, Finland.); Dunbar J ( Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Australia.); Laatikainen T ( Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Australia)
Abstract	AIMS: This research assessed the impact of area-level socio-economic factors on the prevalence and outcomes of type 2 diabetes in North Karelia, Finland. METHODS: All type 2 diabetes patients (n=10,204) were analyzed from the regional electronic patient database during the years 2011 and 2012. The patient's individual laboratory data was used to assess whether hemoglobin A1c (HbA1c) was measured and whether the recommended level of HbA1c <7% (<53 mmol/l) was achieved. The variables describing socio-economic characteristics of postal code areas were retrieved from the database of Statistics Finland. Linear and logistic regression analyses were used to determine associations. RESULTS: HbA1c had been measured in 83% of patients. Over 70% of those with HbA1c measured reached the recommended level of HbA1c. The worse the area-level socio-economic status, the more probably HbA1c was not measured. Achieving the recommended HbA1c level was associated with being female and having a better area-level socio-economic status. The age-adjusted prevalence of type 2 diabetes was not linearly dependent on the socio-economic circumstances of the postal code areas. CONCLUSIONS: This study shows that socio-economic factors at the small area-level are associated with treatment outcomes. The information from the regional electronic patient database linked with area-level socio-economic information could be effectively utilized to improve diabetes care.
File Format	HTM / HTML
ISSN	01688227
Issue Number	3
Volume Number	106
e-ISSN	18728227
Journal	Diabetes Research and Clinical Practice
Language	English
Publisher	Elsevier
Publisher Date	2014-12-01
Publisher Place	Ireland
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Therapy Research Support, Non-u.s. Gov't Prevalence Humans Middle Aged Male Delivery Of Health Care Epidemiology Blood Socioeconomic Factors Journal Article Outcome Assessment (health Care) Adult Female Diabetes Mellitus, Type 2 Retrospective Studies Hemoglobin A, Glycosylated Risk Factors Aged, 80 And Over Metabolism Disease Progression Discipline Endocrinology Finland Disease Management Aged Methods
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism Internal Medicine Endocrinology

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