1. Impact of socio-economic position on health and quality of care in adults with Type 2 diabetes in France: the Entred 2007 study.
- Author
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Fosse-Edorh S, Fagot-Campagna A, Detournay B, Bihan H, Eschwege E, Gautier A, and Druet C
- Subjects
- Aged, Body Mass Index, Combined Modality Therapy economics, Cross-Sectional Studies, Delayed Diagnosis, Diabetes Complications diagnosis, Diabetes Complications economics, Diabetes Complications epidemiology, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 economics, Diabetic Cardiomyopathies complications, Diabetic Cardiomyopathies economics, Diabetic Cardiomyopathies epidemiology, Diabetic Cardiomyopathies prevention & control, Diabetic Foot complications, Diabetic Foot economics, Diabetic Foot epidemiology, Diabetic Foot prevention & control, Female, France epidemiology, Health Care Costs, Health Surveys, Humans, Male, Middle Aged, Obesity complications, Obesity economics, Obesity epidemiology, Obesity prevention & control, Risk Factors, Socioeconomic Factors, Diabetes Complications prevention & control, Diabetes Mellitus, Type 2 therapy, Health Status, Quality of Health Care
- Abstract
Aim: To describe the association between socio-economic position, health status and quality of diabetes care in people with Type 2 diabetes in France, where people may receive full healthcare coverage for chronic disease., Methods: Data from a national cross-sectional survey performed in people pharmacologically treated for diabetes were used. They combined data from medical claims, hospital discharge, questionnaires for patients (n = 3894 with Type 2 diabetes) and their physicians (n = 2485). Socio-economic position was assessed using educational level (low, intermediate, high) and ability to make ends meet (financial difficulties vs. financially comfortable)., Results: People with diabetes reporting financial difficulties were more likely to be smokers (adjusted odds ratio 1.4; 95% CI 1.1-1.6) and obese (adjusted odds ratio 1.3; 95% CI 1.2-1.6) and to have poorer glycaemic control (HbA1c > 64 mmol/mol (8%); adjusted odds ratio 1.4; 95% CI 1.1-1.8), than those who were financially comfortable. They were more likely to have their diabetes diagnosed because of complications (adjusted odds ratio 1.6; 95% CI 1.3-2.0). They were also more likely to have coronary and podiatric complications (adjusted odds ratios 1.3; 95% CI 1.1-1.6 and 1.7; 95% CI 1.4-2.2, respectively). They benefited more often from full coverage (adjusted odds ratio 1.3; 95% CI 1.1-1.6), visited general practitioners more often (ratio of estimated marginal means 1.2; 95% CI 1.1-1.2) but specialists less often (adjusted odds ratio 0.7; 95% CI 0.6-0.8 for a visit to private ophthalmologist). They also felt less well informed about their condition., Conclusions: Despite frequent access to full healthcare coverage, socio-economic position has an impact on the diagnosis of diabetes, health status and quality of diabetes care in France., (© 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.)
- Published
- 2015
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