Maija Sikiö1, Markku Tykkyläinen2, Hilkka Tirkkonen3, Päivi Kekäläinen4, James Dunbar5, Tiina Laatikainen6. 1. Department of Geographical and Historical Studies, University of Eastern Finland, Joensuu, Finland. Electronic address: maija.sikio@uef.fi. 2. Department of Geographical and Historical Studies, University of Eastern Finland, Joensuu, Finland. 3. Health Centre of Outokumpu, Outokumpu, Finland. 4. Department of Internal Medicine, Hospital District of North Karelia, Joensuu, Finland. 5. Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Australia. 6. Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool, Australia; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Hospital District of North Karelia, Joensuu, Finland; Department of Chronic Disease Prevention, National Institute for Health and Welfare (THL), Helsinki, Finland.
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.
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 diabetespatients (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.
Authors: Maija Toivakka; Aki Pihlapuro; Markku Tykkyläinen; Lauri Mehtätalo; Tiina Laatikainen Journal: BMC Public Health Date: 2018-11-14 Impact factor: 3.295
Authors: Teppo Repo; Markku Tykkyläinen; Juha Mustonen; Tuomas T Rissanen; Matti Ketonen; Maija Toivakka; Tiina Laatikainen Journal: Int J Environ Res Public Health Date: 2018-04-11 Impact factor: 3.390