Benjamin J Wheeler1, Rhiannon Braund2, Barbara Galland3, Anastasia Mikuscheva3, Esko Wiltshire4, Craig Jefferies5, Michel de Lange6. 1. Paediatric Endocrinology, Southern District Health Board, Dunedin; Department of Women's and Children's Health, University of Otago, Dunedin. 2. NZ Pharmacovigilance Centre, Preventive and Social Medicine, University of Otago, Dunedin. 3. Department of Women's and Children's Health, University of Otago, Dunedin. 4. Paediatrics and Child Health, University of Otago, Wellington. 5. Starship Children's Health, Auckland. 6. Biostatistics Unit, Dunedin School of Medicine, University of Otago, Dunedin.
Abstract
AIMS: Insulin pump therapy (CSII) is becoming increasingly common for those living with type 1 diabetes (T1D), and has been publicly funded in New Zealand since 2012. The aim of the current study was to examine national uptake of publicly funded pumps from 2012 to 2016, with a focus on the proportion of patients using pumps analysed according to district health board (DHB) as well as demographic characteristics. METHODS: Data from nationally held data collections including the New Zealand Virtual Diabetes Register were used to calculate the overall and subgroup proportions using pumps. Logistic regression analysis was then used to estimate the independent contributions of DHB of residence and sociodemographic characteristics to variations in pump use. RESULTS: Between 2012 and 2016, CSII for those living with T1D (n=17,338) increased from 1.6 to 11.3% overall. However, speed of uptake differed by DHB of residence, ethnicity, degree of deprivation, age and gender. A four-fold difference in uptake between highest and lowest using DHBs was seen after adjusting for known confounders. CONCLUSIONS: From 2012 to 2016 there has been a steadily increasing uptake of CSII. Despite publicly funded access, disparities in use appear to exist, including by DHB of residence as well as traditionally described socio-demographic barriers to healthcare. Efforts to understand and reduce these disparities are required.
AIMS: Insulin pump therapy (CSII) is becoming increasingly common for those living with type 1 diabetes (T1D), and has been publicly funded in New Zealand since 2012. The aim of the current study was to examine national uptake of publicly funded pumps from 2012 to 2016, with a focus on the proportion of patients using pumps analysed according to district health board (DHB) as well as demographic characteristics. METHODS: Data from nationally held data collections including the New Zealand Virtual Diabetes Register were used to calculate the overall and subgroup proportions using pumps. Logistic regression analysis was then used to estimate the independent contributions of DHB of residence and sociodemographic characteristics to variations in pump use. RESULTS: Between 2012 and 2016, CSII for those living with T1D (n=17,338) increased from 1.6 to 11.3% overall. However, speed of uptake differed by DHB of residence, ethnicity, degree of deprivation, age and gender. A four-fold difference in uptake between highest and lowest using DHBs was seen after adjusting for known confounders. CONCLUSIONS: From 2012 to 2016 there has been a steadily increasing uptake of CSII. Despite publicly funded access, disparities in use appear to exist, including by DHB of residence as well as traditionally described socio-demographic barriers to healthcare. Efforts to understand and reduce these disparities are required.
Authors: Shekhar Sehgal; Martin De Bock; Jonathan Williman; Barry Taylor; Mona Elbalshy; Barbara Galland; Rosemary Hall; Ryan Paul; Alisa Boucsein; Shirley Jones; Carla Frewen; Benjamin J Wheeler Journal: J Diabetes Metab Disord Date: 2021-10-31
Authors: Sara Boucher; Miranda Blackwell; Barbara Galland; Martin de Bock; Hamish Crocket; Esko Wiltshire; Paul Tomlinson; Jenny Rayns; Benjamin Wheeler Journal: J Diabetes Metab Disord Date: 2019-12-07