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N Z Med J ; 135(1565): 74-82, 2022 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-36356271

RESUMO

AIM: Lower socio-economic status (SES) is linked to greater morbidity in people with young-onset type 2 (T2D) and type 1 diabetes (T1D). We assessed healthcare utilisation from this population and the impact of SES. METHODS: Retrospective analysis of 1,350 people with T2D and 731 with T1D diagnosed between 15-30 years of age referred to secondary diabetes services in Auckland, New Zealand. Primary care visits, referral to/attendance at diabetes clinics, and hospital admissions were recorded; their relationship to a validated national index of deprivation (NZDep) was assessed. RESULTS: The proportion with primary care attendance was similar in both groups with no significant variation with NZDep. For T2D, NZDep was a predictor of delayed referral (≧1-year post-diagnosis) to diabetes services, following adjustment for age and HbA1c in the year of diagnosis (OR 1.15 for every decile increase in NZDep, 95% CI 1.07-1.24, p=0.0003). The median number of appointments offered over a 2-year period was greater for T1D (2.0 (IQR 0, 7) vs (0 (IQR 0, 2), p<0.001); non-attendance increased with NZDep for T2D (p=0.016). The proportion with hospital admissions was similar in both groups and increased with NZDep (T1D p<0.001, T2D p=0.015). CONCLUSION: SES impacts several measures of healthcare utilisation. Current healthcare models are inadequately servicing people with young-onset T2D.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Humanos , Adolescente , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/terapia , Estudos Retrospectivos , Nova Zelândia/epidemiologia , Pobreza , Atenção à Saúde
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