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Impact of socioeconomic geography on outcomes following hospital discharge for people with diabetes
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Robbins, Tim, Sankaranarayanan, Sailesh, Randeva, Harpal S., Lim Choi Keung, Sarah N. and Arvanitis, Theodoros N. (2021) Impact of socioeconomic geography on outcomes following hospital discharge for people with diabetes. The British Journal of Diabetes, 21 (2). pp. 205-209. doi:10.15277/bjd.2021.305
An open access version can be found in:
Official URL: https://doi.org/10.15277/bjd.2021.305
Abstract
Background: Socioeconomic factors drive poor diabetes outcomes. Little research has assessed the impact of socio-economic factors on outcomes when people with diabetes are discharged from hospital. We evaluate the impact of socioeconomic factors on readmission and mortality.
Methods: We performed a retrospective evaluation of data extracted from an electronic health record of a large UK hospital for all patients discharged with a diabetes diagnosis over 3 years. Data were extracted for 46,357 distinct discharges and matched at patient level to postcode sector socioeconomic data. Outcomes were evaluated against pre-specified diabetes cohorts. Standardised effect sizes were calculated.
Results: Socioeconomic status was statistically significantly associated with 14 of 19 socioeconomic variables in relation to 180-day mortality for a type 2 diabetes mellitus (T2DM) patient cohort; no statistically significant association between mortality and socioeconomic variables in a type 1 diabetes mellitus (T1DM) cohort was noted. Socioeconomic status was significantly associated with one of 19 variables for 28-day readmission in T2DM patient cohorts compared with nine statistically significant variables for T1DM cohorts. Effect sizes were strongest for deprivation indices (Cohen’s D=0.29) and health-related activity impairment (Cohen’s D=0.15).
Conclusion: There is a strong association between geographical socioeconomic status and readmission outcomes for patients with T1DM but only a limited association with mortality. In contrast, mortality for T2DM cohorts is strongly associated with socioeconomic status whilst readmission is not.
| Item Type: | Journal Article | ||||||
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| Subjects: | Q Science > QA Mathematics > QA76 Electronic computers. Computer science. Computer software R Medicine > R Medicine (General) |
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| Divisions: | Faculty of Science > WMG (Formerly the Warwick Manufacturing Group) | ||||||
| Journal or Publication Title: | The British Journal of Diabetes | ||||||
| Publisher: | BJDVD Ltd | ||||||
| ISSN: | 2397-6241 | ||||||
| Official Date: | December 2021 | ||||||
| Dates: |
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| Volume: | 21 | ||||||
| Number: | 2 | ||||||
| Page Range: | pp. 205-209 | ||||||
| DOI: | 10.15277/bjd.2021.305 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| Open Access Version: |
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