Social disparities in diabetes care: a general population study in Denmark

<p><b>Objective:</b> We investigated the association between socioeconomic factors and the attainment of treatment goals and pharmacotherapy in patients with type 2 diabetes in Denmark.</p> <p><b>Design:</b> A cross-sectional population study.</p> <p><b>Setting:</b> The municipality of Naestved, Denmark.</p> <p><b>Subjects:</b> We studied 907 patients with type 2 diabetes identified from a random sample of 21,205 Danish citizens.</p> <p><b>Main outcome measures:</b> The proportion of patients who were not achieving goals for diabetes care based on their HbA_1c, LDL-cholesterol, blood pressure, and lifestyle, and the proportion of patients who were treated with antihypertensive and cholesterol- and glucose-lowering medication.</p> <p><b>Methods:</b> We investigated the association of the socioeconomic factors such as age, gender, education, occupation, income, and civil status and attainment of treatment goals and pharmacotherapy in logistic regression analyses. We investigated effect modification of cardiovascular disease and kidney disease.</p> <p><b>Results:</b> Middle age (40–65 years), low education level (i.e. basic schooling), and low household income (i.e. less than 21,400 € per year) were associated with nonattainment of goals for diabetes care. The association of socioeconomic factors with attainment of individual treatment goals varied. Patients with low socioeconomic status were more often obese, physically inactive, smoking, and had elevated blood pressure. Socioeconomic factors were not associated with treatment goals for hyperglycemia. Socioeconomic factors were inconsistently associated with pharmacotherapy. There was no difference in contacts to general practitioners according to SES.</p> <p><b>Conclusions:</b> In a country with free access to health care, the socioeconomic factors such as middle age, low education, and low income were associated with nonattainment of goals for diabetes care.KEY POINTS</p><p>Middle age, low education, and low income were associated with nonattainment of goals for diabetes care, especially for lifestyle goals.</p><p>Patients with low socioeconomic status were more often obese, physically inactive, smoking, and had elevated blood pressure.</p><p>Association of socioeconomic factors with pharmacotherapy was inconsistent.</p><p></p> <p>Middle age, low education, and low income were associated with nonattainment of goals for diabetes care, especially for lifestyle goals.</p> <p>Patients with low socioeconomic status were more often obese, physically inactive, smoking, and had elevated blood pressure.</p> <p>Association of socioeconomic factors with pharmacotherapy was inconsistent.</p

Additional file 1: of Use of diagnostic tests and the appropriateness of the treatment decision in patients with suspected urinary tract infection in primary care in Denmark – observational study

Table S1. Predictors for using diagnostic tests in patients with suspected UTI. Summary of the results of the logistic regression models to test the predictors for using microscopy, urine culture in practice or urine culture at the hospital. Table S2. Accuracy of urine culture in practice. Distribution of the interpretation of the test in relation to the reference standard. Table S3. Accuracy of urine culture in the hospital. Distribution of the interpretation of the test in relation to the reference standard. (DOCX 22 kb