Age-related differences in diabetes care outcomes in Korea: a retrospective cohort study

BMC Geriatrics

Baegju Na¹  Martin Hyde²  Namhoon Kim³  Young-duk Yun⁴  Sujin Baek⁴  Myung Ki⁵ 

[1] Department of Preventive Medicine, College of Medicine, Konyang University, Konyang Univ. Gwanjeo Campus, Gasuwon-dong, Seo-gu, Daejeon 302-833, Korea;Stress Research Institute, Stockholm University, Stockholm, Sweden;Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea;Institute for Health Insurance Policy Research, National Health Insurance Service, Seoul, Korea;Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Korea

关键词: Risk factors;    Glycemic control;    Hospitalization;    Diabetes management among older patients;    Type 2 diabetes;   

Others  :  1089909
DOI  :  10.1186/1471-2318-14-111

 received in 2014-04-30, accepted in 2014-09-29,  发布年份 2014

【 摘 要 】

Background

Age-related differences in diabetes outcomes are important both for clinical and policy considerations. To clarify the basis of such differences, we investigated patterns of associations for age in relation to hospitalization and glycemic control and examined the role of other factors.

Methods

4471 patients with diabetes aged 40–79 years were drawn from a retrospectively retrieved National Health Insurance Cohort. Using logistic regression, risk factors measured over the two years (2007–2008) were examined for their associations with hospitalization and poor glycemic control during the last year (2009) of follow-up.

Results

Compared to the middle-aged patients, older patients were more likely to have been hospitalized (Adjusted odds ratio (OR_adjusted) = 1.97(95% CI = 1.28, 3.04) for the oldest group (ages 70–79) vs youngest group (ages 40–49)) but less likely to have poor glycemic control (OR_adjusted = 0.45 (95% CI = 0.37, 0.56) for the oldest group vs youngest group). Older patients were also less likely to be obese but had more complications, longer duration of diabetes, lower continuity of care, and higher blood pressure and total cholesterol level. The pattern of associations for hospitalization and glycemic control was not uniform across the risk factors, sharing only a few common factors such as the duration of diabetes and blood pressure. In general, poor glycemic control was affected predominantly by metabolic management, while hospitalization was strongly related to functional status (i.e., number of complications) and care quality measures (i.e., continuity of care).

Conclusion

Hospitalization was higher among the older diabetic patients, despite better glycemic control. Factors were differently associated with the two diabetes-related outcomes, providing more comprehensive risk profiles for hospitalization. The co-existence of improved glycemic control and increased hospitalization among older diabetic patients suggests an extension of a geriatric evaluation to wider functional and comorbidity status.

【 授权许可】

   
2014 Ki et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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