Disparities in Attending Diabetes Self-management Programs
Disparities in Attending Diabetes Self-management Programs
There were 50,363 adults newly diagnosed with diabetes in Ontario between January and June 2006. Of them, 1,205 were excluded because they died before December 31, 128 were excluded because of missing address information needed to determine baseline demographic characteristics, and 2,477 were excluded because, as recent immigrants to Ontario, we could not distinguish incident from prevalent diabetes. Of the final cohort of 46,553 people, only 9,568 (20.6%) attended a diabetes self-management education program within 6 months of their diabetes diagnosis. In the subgroup of 31,580 patients who were diagnosed with diabetes between January and April 2006, 20.6% had a program visit within 6 months, growing only to 22.0% when follow-up was lengthened to 8 months.
Unadjusted and fully adjusted associations between the baseline characteristics and diabetes self-management education program attendance are shown in Table 1. Increasing age was associated with decreased attendance in both the unadjusted analysis and in the adjusted regression model, with only 11.9% of patients aged ≥80 at diagnosis attending a diabetes self-management education program. In contrast, increasing socioeconomic status was associated with increased attendance. There were no significant differences in program attendance between men and women. The largest absolute difference in attendance was between patients residing in rural regions versus those in non-rural regions, with nearly one-third of rural residents attending a diabetes self-management education program. Recent immigrants were markedly less likely to attend a program. Patients with no family physician visits in the preceding year and those with seven or more visits were less likely to attend a diabetes self-management education program than those with one to six visits in the preceding year. Finally, patients with mental health conditions or medical comorbidity were somewhat less likely to attend.
Results
There were 50,363 adults newly diagnosed with diabetes in Ontario between January and June 2006. Of them, 1,205 were excluded because they died before December 31, 128 were excluded because of missing address information needed to determine baseline demographic characteristics, and 2,477 were excluded because, as recent immigrants to Ontario, we could not distinguish incident from prevalent diabetes. Of the final cohort of 46,553 people, only 9,568 (20.6%) attended a diabetes self-management education program within 6 months of their diabetes diagnosis. In the subgroup of 31,580 patients who were diagnosed with diabetes between January and April 2006, 20.6% had a program visit within 6 months, growing only to 22.0% when follow-up was lengthened to 8 months.
Unadjusted and fully adjusted associations between the baseline characteristics and diabetes self-management education program attendance are shown in Table 1. Increasing age was associated with decreased attendance in both the unadjusted analysis and in the adjusted regression model, with only 11.9% of patients aged ≥80 at diagnosis attending a diabetes self-management education program. In contrast, increasing socioeconomic status was associated with increased attendance. There were no significant differences in program attendance between men and women. The largest absolute difference in attendance was between patients residing in rural regions versus those in non-rural regions, with nearly one-third of rural residents attending a diabetes self-management education program. Recent immigrants were markedly less likely to attend a program. Patients with no family physician visits in the preceding year and those with seven or more visits were less likely to attend a diabetes self-management education program than those with one to six visits in the preceding year. Finally, patients with mental health conditions or medical comorbidity were somewhat less likely to attend.
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