Urban-rural disparity in lower extremities amputation in patients with diabetes after nearly two decades of universal health Insurance in Taiwan.
BMC Public Health
; 20(1): 212, 2020 Feb 11.
Article
em En
| MEDLINE
| ID: mdl-32046698
ABSTRACT
BACKGROUND:
To assess the prevalence of urban-rural disparity in lower extremities amputation (LEA) among patients with diabetes and to explore whether patient-related or physician-related factors might have contributed to such disparity.METHODS:
This was a population-based study including patients with diabetes aged ≥55 years from 2009 to 2013. Among them, 9236 received LEA. Data were retrieved from Taiwan's National Health Insurance (NHI) claims. A multiple Poisson regression model was also employed to assess the urban-rural difference in LEA prevalence by simultaneously taking into account socio-demographic variables and density of practicing physicians.RESULTS:
Between 2009 and 2013, the annual prevalence of LEA declined from 30.4 to 20.5 per 10,000 patients. Compared to patients from urban areas, those who lived in sub-urban and rural areas suffered from a significantly elevated prevalence of LEA, with a prevalence rate ratio (PRR) of 1.47 (95% CI, 1.39-1.55) and 1.68 (95% CI, 1.56-1.82), respectively. The density of physicians who presumably provided diabetes care can barely explain the urban-rural disparity in LEA prevalence.CONCLUSIONS:
Although the universal health insurance has largely removed financial barriers to health care, the urban-rural disparity in LEA prevalence still exists in Taiwan after nearly two decades of the NHI program.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
População Rural
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População Urbana
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Cobertura Universal do Seguro de Saúde
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Extremidade Inferior
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Diabetes Mellitus
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Disparidades nos Níveis de Saúde
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Amputação Cirúrgica
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article