Gillian L. Booth|Janet E. Hux|Jiming Fang|Ben Chan
Time Trends and Geographic Disparities in Acute Complications of Diabetes in Ontario, Canada
University of Toronto|Institute for Clinical Evaluative Sciences|University of Toronto|Institute for Clinical Evaluative Sciences|Sunnybrook Health Science Centre|Health Sciences Centre|Institute for Clinical Evaluative Sciences|Institute for Clinical Evaluative Sciences|University of Toronto|Saskatchewan Health Quality Council
objectivethis study examines whether acute diabetes complication rates fallen recent years whether geographic factors influence trends research design methodsa populationbased timetrend analysis acute complications diabetes conducted using linked administrative census data ontario canada study population included adults identified provincewide electronic diabetes registry 1994 1999 n 577659 primary outcome hospitalizations hyper hypoglycemia emergency department visits diabetes resultsbetween 1994 1999 rates hospitalization hyper hypoglycemic emergencies decreased 325 769 respectively emergency department visits diabetes fell 239 multivariate analysis fiscal year independent predictor acute diabetes complications individuals cohort experiencing decline risk 6 per year either hospitalized hyper hypoglycemia requiring emergency department visit diabetes accounting variation physician service use diabetic individuals living rural areas aboriginal communities nearly twice likely acute complication whereas residing remote areas province nearly three times likely experience event conclusionsalthough findings suggest overall improvement diabetes care ontario certain subgroups population continue experience higher rates complications potentially preventable good ambulatory care measures improve access timely effective outpatient care may reduce rates acute complications among diabetic population