1469Inequalities in diabetes management by area deprivation: the mediating role of healthcare resource distribution

Abstract

Abstract Background We sought to identify the existence of regional socioeconomic inequalities in diabetes management and to examine whether the distribution of healthcare resources could explain regional inequalities in diabetes management. Methods Data were derived from the Korean Community Health Survey in 2018. Our study subjects included 23,760 participants who have been diagnosed with diabetes by a doctor. The dependent variables were self-reported glycemic control, Hemoglobin A1c (HbA1c) testing, recognition of the term HbA1c, and diabetic complications testing. Socio-demographics, health behavior-related factors, and factors related to regional healthcare resources were considered as potential mediating variables in explaining the association between diabetes management and area deprivation. A multilevel logistic regression analysis was used. Results Compared to the least deprived area, the likelihood of not taking HbA1c tests, not recognizing the term HbA1c, and not taking diabetic complication tests in the most deprived area were approximately 1.5, 2.6, and 2 times higher, respectively. In the most deprived areas, the coefficient of variation value of clinics was the highest and the number of doctors was the lowest. Regional healthcare resource factors explained regional inequalities in managing diabetes by 14% to 18%, especially in the most deprived area. Conclusions Policy interventions for more even distribution of healthcare resources would contribute to reducing the magnitude of regional inequalities in diabetes management. Key messages Our study suggests that reducing inequality in diabetes management could be possible through the appropriate allocation of healthcare resources.