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01-12-2011 | Research | Uitgave 1/2011 Open Access

Journal of Foot and Ankle Research 1/2011

The impact of socio-economic disadvantage on rates of hospital separations for diabetes-related foot disease in Victoria, Australia

Tijdschrift:
Journal of Foot and Ankle Research > Uitgave 1/2011
Auteurs:
Shan M Bergin, Caroline A Brand, Peter G Colman, Don A Campbell
Belangrijke opmerkingen

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

SB conceived of the study, designed the study methodology, collected and analysed data and drafted the manuscript. CB advised on study methodology and provided editorial support for the manuscript. PC advised on study methodology and provided editorial support for the manuscript. DC advised on study methodology, data analysis and provided editorial support for the manuscript. All authors read and approved the final manuscript.

Abstract

Background

Information describing variation in health outcomes for individuals with diabetes related foot disease, across socioeconomic strata is lacking. The aim of this study was to investigate variation in rates of hospital separations for diabetes related foot disease and the relationship with levels of social advantage and disadvantage.

Methods

Using the Index of Relative Socioeconomic Disadvantage (IRSD) each local government area (LGA) across Victoria was ranked from most to least disadvantaged. Those LGAs ranked at the lowest end of the scale and therefore at greater disadvantage (Group D) were compared with those at the highest end of the scale (Group A), in terms of total and per capita hospital separations for peripheral neuropathy, peripheral vascular disease, foot ulceration, cellulitis and osteomyelitis and amputation. Hospital separations data were compiled from the Victorian Admitted Episodes Database.

Results

Total and per capita separations were 2,268 (75.3/1,000 with diabetes) and 2,734 (62.3/1,000 with diabetes) for Group D and Group A respectively. Most notable variation was for foot ulceration (Group D, 18.1/1,000 versus Group A, 12.7/1,000, rate ratio 1.4, 95% CI 1.3, 1.6) and below knee amputation (Group D 7.4/1,000 versus Group A 4.1/1,000, rate ratio 1.8, 95% CI 1.5, 2.2). Males recorded a greater overall number of hospital separations across both socioeconomic strata with 66.2% of all separations for Group D and 81.0% of all separations for Group A recorded by males. However, when comparing mean age, males from Group D tended to be younger compared with males from Group A (mean age; 53.0 years versus 68.7 years).

Conclusion

Variation appears to exist for hospital separations for diabetes related foot disease across socioeconomic strata. Specific strategies should be incorporated into health policy and planning to combat disparities between health outcomes and social status.

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Andere artikelen Uitgave 1/2011

Journal of Foot and Ankle Research 1/2011Naar de uitgave