Association between income levels and irregular physician visits after a health checkup, and its consequent effect on glycemic control among employees: A retrospective propensity score-matched cohort study
Association between income levels and irregular physician visits after a health checkup, and its consequent effect on glycemic control among employees: A retrospective propensity score-matched cohort study
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DOI：
10.1111/jdi.13025
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发表时间：
2019-09-01
影响因子：
3.2
通讯作者：
Maeda, Toshiki
中科院分区：
文献类型：
--
作者：
Nishi, Takumi;Babazono, Akira;Maeda, Toshiki
目的/介绍-本研究旨在评估收入水平对医生就诊模式的影响，并量化不规则的医生就诊对日本员工健康保险受益人血糖控制的影响。材料与方法我们从日本健康保险协会福冈分支获得了未经治疗的糖尿病患者的特定健康检查数据。我们选择了2，981名保险受益人，并将650名和2，331名患者分别分为定期就诊组和不定期就诊组。我们采用倾向评分匹配来选择适当的对照组。结果与标准月收入= 5,000美元的人群相比：优势比为0.58（95%可信区间为0.39-0.86）。在倾向评分匹配并调整协变量后，不定期访视组倾向于血糖控制较差;糖化血红蛋白增加>= 0.5：比值比1.90（95%置信区间1.30-2.77），>= 1.0：比值比2.75（95%可信区间1.56-4.82）和>= 20%相对：比值比3.18（95%可信区间1.46-6.92）。结论：我们澄清了收入和不规则就诊之间存在显著关系，这导致血糖控制不良。这些发现将有助于更有效的疾病管理。
Aims/Introduction The present study aimed to evaluate the effects of income levels on physician visit patterns and to quantify the consequent impact of irregular physician visits on glycemic control among employees' health insurance beneficiaries in Japan. Materials and Methods We obtained specific health checkup data of untreated diabetes patients from the Fukuoka branch of the Japanese Health Insurance Association. We selected 2,981 insurance beneficiaries and classified 650 and 2,331 patients into, respectively, the regular visit and irregular visit group. We implemented propensity score matching to select an adequate control group. Results Compared with those with a standard monthly income =$5,000: odds ratio 0.58 (95% confidence interval 0.39-0.86). After propensity score matching and adjusting for covariates, the irregular visit group tended to have poor glycemic control; increased glycated hemoglobin >= 0.5: odds ratio 1.90 (95% confidence interval 1.30-2.77), >= 1.0: odds ratio 2.75 (95% confidence interval 1.56-4.82) and >= 20% relatively: odds ratio 3.18 (95% confidence interval 1.46-6.92). Conclusions We clarified that there was a significant relationship between income and irregular visits, and this consequently resulted in poor glycemic control. These findings would be useful for more effective disease management.