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Association between area-level socioeconomic status, accessibility and diabetes-related hospitalisations: a cross-sectional analysis of data from Western Victoria, Australia.

Publication ,  Journal Article
Sajjad, MA; Holloway-Kew, KL; Mohebbi, M; Kotowicz, MA; de Abreu, LLF; Livingston, PM; Khasraw, M; Hakkennes, S; Dunning, TL; Brumby, S ...
Published in: BMJ Open
May 22, 2019

OBJECTIVE: Hospitalisation rates for many chronic conditions are higher in socioeconomically disadvantaged and less accessible areas. We aimed to map diabetes hospitalisation rates by local government area (LGA) across Western Victoria, Australia, and investigate their association with socioeconomic status (SES) and accessibility/remoteness. DESIGN: Cross-sectional study METHODS: Data were acquired from the Victorian Admitted Episodes Dataset for all hospitalisations (public and private) with a diagnosis of type 1 or type 2 diabetes mellitus during 2011-2014. Crude and age-standardised hospitalisation rates (per 1000 population per year) were calculated by LGA for men, women and combined data. Associations between accessibility (Accessibility/Remoteness Index of Australia, ARIA), SES (Index of Relative Socioeconomic Advantage and Disadvantage, IRSAD) and diabetes hospitalisation were investigated using Poisson regression analyses. RESULTS: Higher LGA-level accessibility and SES were associated with higher rates of type 1 and type 2 diabetes hospitalisation, overall and for each sex. For type 1 diabetes, higher accessibility (ARIA category) was associated with higher hospitalisation rates (men incidence rate ratio [IRR]=2.14, 95% CI 1.64 to 2.80; women IRR=2.45, 95% CI 1.87 to 3.19; combined IRR=2.30, 95% CI 1.69 to 3.13; all p<0.05). Higher socioeconomic advantage (IRSAD decile) was also associated with higher hospitalisation rates (men IRR=1.25, 95% CI 1.09 to 1.43; women IRR=1.32, 95% CI 1.16 to 1.51; combined IRR=1.23, 95% CI 1.07 to 1.42; all p<0.05). Similarly, for type 2 diabetes, higher accessibility (ARIA category) was associated with higher hospitalisation rates (men IRR=2.49, 95% CI 1.81 to 3.43; women IRR=2.34, 95% CI 1.69 to 3.25; combined IRR=2.32, 95% CI 1.66 to 3.25; all p<0.05) and higher socioeconomic advantage (IRSAD decile) was also associated with higher hospitalisation rates (men IRR=1.15, 95% CI 1.02 to 1.30; women IRR=1.14, 95% CI 1.01 to 1.28; combined IRR=1.13, 95% CI 1.00 to 1.27; all p<0.05). CONCLUSION: Our observations could indicate self-motivated treatment seeking, and better specialist and hospital services availability in the advantaged and accessible areas in the study region. The determinants for such variations in hospitalisation rates, however, are multifaceted and warrant further research.

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Published In

BMJ Open

DOI

EISSN

2044-6055

Publication Date

May 22, 2019

Volume

9

Issue

5

Start / End Page

e026880

Location

England

Related Subject Headings

  • Victoria
  • Social Class
  • Patient Acceptance of Health Care
  • Motivation
  • Middle Aged
  • Male
  • Local Government
  • Humans
  • Hospitalization
  • Health Services Accessibility
 

Citation

APA
Chicago
ICMJE
MLA
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Sajjad, M. A., Holloway-Kew, K. L., Mohebbi, M., Kotowicz, M. A., de Abreu, L. L. F., Livingston, P. M., … Pasco, J. A. (2019). Association between area-level socioeconomic status, accessibility and diabetes-related hospitalisations: a cross-sectional analysis of data from Western Victoria, Australia. BMJ Open, 9(5), e026880. https://doi.org/10.1136/bmjopen-2018-026880
Sajjad, Muhammad A., Kara L. Holloway-Kew, Mohammadreza Mohebbi, Mark A. Kotowicz, Lelia L. F. de Abreu, Patricia M. Livingston, Mustafa Khasraw, et al. “Association between area-level socioeconomic status, accessibility and diabetes-related hospitalisations: a cross-sectional analysis of data from Western Victoria, Australia.BMJ Open 9, no. 5 (May 22, 2019): e026880. https://doi.org/10.1136/bmjopen-2018-026880.
Sajjad MA, Holloway-Kew KL, Mohebbi M, Kotowicz MA, de Abreu LLF, Livingston PM, et al. Association between area-level socioeconomic status, accessibility and diabetes-related hospitalisations: a cross-sectional analysis of data from Western Victoria, Australia. BMJ Open. 2019 May 22;9(5):e026880.
Sajjad, Muhammad A., et al. “Association between area-level socioeconomic status, accessibility and diabetes-related hospitalisations: a cross-sectional analysis of data from Western Victoria, Australia.BMJ Open, vol. 9, no. 5, May 2019, p. e026880. Pubmed, doi:10.1136/bmjopen-2018-026880.
Sajjad MA, Holloway-Kew KL, Mohebbi M, Kotowicz MA, de Abreu LLF, Livingston PM, Khasraw M, Hakkennes S, Dunning TL, Brumby S, Page RS, Sutherland AG, Venkatesh S, Williams LJ, Brennan-Olsen SL, Pasco JA. Association between area-level socioeconomic status, accessibility and diabetes-related hospitalisations: a cross-sectional analysis of data from Western Victoria, Australia. BMJ Open. 2019 May 22;9(5):e026880.

Published In

BMJ Open

DOI

EISSN

2044-6055

Publication Date

May 22, 2019

Volume

9

Issue

5

Start / End Page

e026880

Location

England

Related Subject Headings

  • Victoria
  • Social Class
  • Patient Acceptance of Health Care
  • Motivation
  • Middle Aged
  • Male
  • Local Government
  • Humans
  • Hospitalization
  • Health Services Accessibility