Socio-Economic Status and Diabetes-Related Hospital Admissions: A Cross-Sectional Study of People with Diagnosed Diabetes
Abstract Number: 1000-P
Authors: SARAH WILD, JOHN MCKNIGHT, ALEX MCCONNACHIE, ROBERT LINDSAY, Edinburgh, United Kingdom, Glasgow, United Kingdom
Institutions: Edinburgh, United Kingdom; Glasgow, United Kingdom
Results: The purpose of this study was to investigate the association between socio-economic status (SES) and history of hospital admission for diabetes-related outcomes. We performed a cross-sectional study of data for 35,925 people with diagnosed diabetes in Scotland using an area-based measure of SES. Data on demographic and risk factors, history of hospital admission for cardiovascular disease, renal disease and diabetes emergencies were obtained from linked diabetes register and hospital data. Comparisons by quintile of SES were made before and after adjusting for other factors using multivariable logistic regression. Compared to people in the most affluent quintile (Q1) people in the most deprived quintile (Q5) of SES were more likely to have hospital admission records for diabetic kidney disease [DKD] (2.4% vs 2.0%, p=0.026), diabetic ketoacidosis (3.5% vs 3.0%, p=0.016), hypoglycemia (1.8% vs 1.4%, p=0.017), ischemic heart disease [IHD] (22% vs 17%, p <0.0001), stroke (6.8% vs 5.1%, p<0.0001) and peripheral vascular disease [PVD] (4.1% vs 2.1%, p<0.0001). An independent effect of SES was observed for all outcomes except DKD after adjusting for potential confounding factors (including age, sex, type of diabetes, time since diagnosis of diabetes, smoking status, body mass index, glycosylated hemoglobin, estimated glomerular filtration rate, cholesterol and systolic blood pressure) (see table for odds ratios[OR] and 95% confidence intervals[CI]). We conclude that low SES is associated with increased odds of history of hospital admission with diabetes related complications and that addressing differences in current risk factor levels is unlikely to be sufficient to remove socio-economic inequalities. Measures of SES may be valuable in risk scores and in comparing health care quality for people with diabetes.