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新诊断糖尿病患者健康结局的残疾相关差异:一项回顾性队列研究。

Disability-related disparities in health outcomes among newly diagnosed diabetic patients: A retrospective cohort.

机构信息

Department of Healthcare Policy Research, Korea Institute for Health and Social Affairs, Sejong-si, 30147, Republic of Korea.

Department of Health and Medical Information, Myongji College, 134, Gajwa-ro, Seodaemun-gu, Seoul, 03656, Republic of Korea.

出版信息

BMC Public Health. 2024 Aug 13;24(1):2207. doi: 10.1186/s12889-024-19690-5.

Abstract

BACKGROUND

A distinct gap in the literature persists regarding the health outcome of individuals with Type 2 diabetes who also have disabilities. This study aimed to investigate potential disparities in events occurrence among diabetes patients across various disability stages.

METHODS

We conducted a retrospective cohort study on patients newly diagnosed with diabetes in 2013 and 2014, aged ≥ 18 years, and followed them until December 2021, using data from the Korean National Health Insurance database. All-cause mortality and hospitalization for diabetes mellitus and cardio-cerebrovascular diseases (CVD) was assessed.

RESULTS

The study included 26,085 patients, encompassing individuals without disabilities and those with physical, visual, hearing and speech, intellectual and developmental, and mental disabilities. After adjustment, individuals with disabilities had a higher risk of all-cause death (adjusted hazard ratio [aHR]: 1.25, 95% CI: 1.07-1.48) compared to those without disabilities. In particular, severe disabilities and hearing and speech disabilities showed significantly higher risks of all-cause death (aHR: 1.40, 95% CI: 1.06-1.85 and aHR: 1.58, 95% CI: 1.17-2.15, respectively), with marginal significance for mild disabilities (aHR: 1.20, 95% CI: 0.99-1.45) and mental disorders (aHR: 1.92, 95% CI: 0.98-3.73). Patients with disabilities also had significantly increased risks of CVD-related first admissions (aHR: 1.30, 95% CI: 1.07-1.56) and diabetes-related first admissions (aHR: 1.31, 95% CI: 1.20-1.43) compared to those without disabilities.

CONCLUSIONS

This study underscores the urgent need for public health policies to prioritize individuals with disabilities and diabetes, addressing the disparities in health outcome.

摘要

背景

目前文献中仍存在明显的差距,即患有 2 型糖尿病的个体同时存在残疾时的健康结果。本研究旨在调查不同残疾阶段的糖尿病患者发生事件的潜在差异。

方法

我们对 2013 年和 2014 年新诊断为糖尿病的年龄≥18 岁的患者进行了回顾性队列研究,并使用韩国国家健康保险数据库的数据对他们进行了随访,直至 2021 年 12 月。评估了全因死亡率和因糖尿病和心血管疾病(CVD)住院的情况。

结果

该研究纳入了 26085 名患者,包括无残疾和有身体、视力、听力和言语、智力和发育以及精神残疾的患者。调整后,残疾患者的全因死亡风险较高(调整后的危险比[aHR]:1.25,95%可信区间[CI]:1.07-1.48)。特别是严重残疾和听力言语残疾患者的全因死亡风险显著较高(aHR:1.40,95%CI:1.06-1.85 和 aHR:1.58,95%CI:1.17-2.15),轻度残疾(aHR:1.20,95%CI:0.99-1.45)和精神障碍(aHR:1.92,95%CI:0.98-3.73)的全因死亡风险有边际显著意义。残疾患者还存在 CVD 相关首次入院(aHR:1.30,95%CI:1.07-1.56)和糖尿病相关首次入院(aHR:1.31,95%CI:1.20-1.43)的风险显著升高。

结论

本研究强调了公共卫生政策优先考虑残疾和糖尿病患者的紧迫性,以解决健康结果的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2be8/11323359/23a6554c6568/12889_2024_19690_Fig1_HTML.jpg

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