Risk of hospitalization for diabetic macrovascular complications and in-hospital mortality with irregular physician visits using propensity score matching
Article first published online: 4 DEC 2013
© 2013 The Authors. Journal of Diabetes Investigation published by Asian Association of the Study of Diabetes (AASD) and Wiley Publishing Asia Pty Ltd
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Journal of Diabetes Investigation
Volume 5, Issue 4, pages 428–434, July 2014
How to Cite
J Diabetes Invest 2014; 5: 428–434
- Issue published online: 18 JUL 2014
- Article first published online: 4 DEC 2013
- Manuscript Accepted: 9 SEP 2013
- Manuscript Revised: 26 AUG 2013
- Manuscript Received: 23 MAY 2013
- Diabetic macrovascular complications;
- Irregular visits
The objective of the present study was to evaluate the risk of diabetic macrovascular complications and in-hospital mortality among diabetic patients with irregular physician visits.
Materials and Methods
We carried out a health insurance-based retrospective cohort study using claims data from diabetic patients who were newly hospitalized between April 2010 and September 2010 among beneficiaries of the Fukuoka National Health Insurance Organization. Regular visits were defined as physician visits for diabetes mellitus at least every 3 months between April 2009 and March 2010, whereas other visits or no visits were defined as irregular visits. We assigned 5,940 patients to the regular visit or the irregular visit groups using propensity score matching. We compared in-hospital mortality and hospitalization for diabetic macrovascular complications between the two groups by multiple logistic regression models.
The irregular visit group had a significantly higher risk of hospitalization for acute myocardial infarction (AMI), ischemic heart diseases (IHDs) except AMI, all IHDs, all strokes and diabetic macrovascular complications than did the regular visit group. Adjusted odds ratios for AMI, IHDs except AMI, all IHDs, all strokes, and diabetic macrovascular complications were 3.52 (95% confidence interval [CI] 1.79–6.96), 1.25 (95% CI 1.02–1.54), 1.37 (95% CI 1.12–1.66), 1.29 (95% CI 1.04–1.60), and 1.28 (95% CI 1.10–1.48), respectively.
The present study shows that the irregular visit group had significantly higher risks of hospitalization for IHD and stroke among diabetic patients. Insurers need to motivate diabetic beneficiaries to make regular visits to physicians.