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Acute circulatory complications in people with diabetes mellitus type 2: How admission varies between urban and rural Victoria
Author(s) -
Gardiner Samantha,
Robins Shalley,
Terry Daniel
Publication year - 2019
Publication title -
australian journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.48
H-Index - 49
eISSN - 1440-1584
pISSN - 1038-5282
DOI - 10.1111/ajr.12459
Subject(s) - medicine , socioeconomic status , rurality , diabetes mellitus , emergency medicine , rural area , emergency department , mortality rate , metropolitan area , demography , population , environmental health , nursing , pathology , sociology , endocrinology
Objective To identify the extent to which rurality influences the admission and mortality rates for acute circulatory complications among people with type 2 diabetes mellitus. Design Retrospective study. Setting All Victorian hospitals. Participants State‐wide hospital admissions from 1 July 2010 to 30 June 2015 using the Victorian Admitted Episodes Dataset. Data included patients with type 2 diabetes mellitus and diagnosis of acute cardiovascular events, acute cerebrovascular haemorrhage or infarction, acute peripheral vascular events or hypertensive diseases. Main outcome measure Rates of admission and mortality were calculated for local government areas and Department of Health regions. Regression analysis identified the influence between admission rates and various predictor variables. Results In total, 5785 emergency hospital admissions occurred during the study period, with the highest and lowest mortality and admission rates occurring in rural areas. Moderately high admission rates were identified in urban areas. Cardiovascular events far outnumbered other acute circulatory admissions. Regression analysis identified a number of significant socioeconomic variables, primarily for metropolitan residents. Socioeconomic disadvantage was the only significant factor in rural areas. Conclusion Victorian admission and mortality rates for acute circulatory complications are greatest in rural areas; yet, there is considerable heterogeneity in the admission rates within both rural and metropolitan areas. Furthermore, socioeconomic status is more influential than remoteness in determining emergency admissions. Further research needs to investigate the particular variables that lead to poorer outcomes rurally, investigate socioeconomic disadvantage in rural areas and have greater emphasis on peripheral vascular disease prevention.