Background: Socioeconomic deprivation is an important determinant of health.
Objectives: This study examined the relationship between incidence of hospital admissions for patients with Type 1 diabetes mellitus (T1DM) and their socioeconomic deprivation.
Methods: All hospital admissions of patients with T1DM from 0 to16 years were identified during a 5-year period between 2007 and 2012 using the hospital episodes statistics database (HES). Each hospital admission was classified as either an accident and emergency (A&E) admission or inpatient ward admissions. Causes of admissions were evaluated from individual hospital medical records. Socioeconomic status of individual patients with T1DM was measured using the deprivation data obtained by cross-referencing postcodes with indices of multiple deprivation (IMD) 2010 for overall deprivation scores. The IMD for 32 484 small geographic areas (lower super output areas) in England are ranked from 1 (most deprived) to 32 482 (least deprived). The Spearman rank correlation coefficient looked at associations between IMD indices and admissions rate.
Results: Records from the 135 (65 F: 69 M) patients showed a significant correlation was found between hospital admission rates and overall deprivation score (r=−0.18, P=0.04). Patients living in deprived areas were more likely to self-present to A&E (r=−0.24, P=0.02) but there were no significant associations between inpatient ward admissions and overall deprivation scores (r=−0.14, P=0.17). Analysis of individual medical records show that patients with T1DM living in deprived areas were more likely to have a hospital admission for diabetes related problems (r=−0.50, P=0.003). There was no association between non-diabetes related hospital admissions with overall deprivation scores (r=−0.01, P=0.27).
Conclusions: Early intervention from primary care and specialist diabetes nurses within the community in deprived areas may be effective in reducing hospital admissions for diabetes-related problems. We believe this has significance for planning health care resources for children and young people with T1DM in the future.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology