Abstract 9849: Self-Reported Health Care Utilization Patterns in Type 2 Diabetes Adults with and without Comorbid Heart Failure in Ethiopia

Abstract

Introduction: Health care utilization (HCU) is an important outcome measure in type 2 diabetes (T2D) management. Little is known concerning differences in HCU patterns between T2D adults with and without heart failure (HF). Aim: This cross-sectional study compared differences in sociodemographic, clinical characteristics and self-care behaviors on HCU patterns between T2D adults with and without HF. Methods: Participants included 210 T2D adults (105 without HF and 105 with HF) from Tikur Anbessa Specialized Referral Hospital in Ethiopia. The Diabetes Health Care Utilization (DHCU) tool was adapted to measure self-reported HCU. It consists of 5 questions asking about the frequency of visits to provider, emergency room, foot examination, total days in hospital in the past 6 months, and last month(s) of eye examination. The score range from 0 (no HCU) to 7 (high utilization) with high score indicating higher utilization in all dimensions except for eye examination. The Mann-Whitney U and Kruskal-Wallis tests were used for data analysis. Results: HCU ranged from 0 to 7 visits to provider, 0 to 3 emergency room visits, 0 to 6 foot examinations, 0 to 11 days in hospital, and 0 to 96 months since previous eye examination. T2D adults with HF had significantly higher emergency room visits ( p = 0.03) and total days in hospital ( P = 0.021). In T2D adults with HF, persons who lived alone had significantly higher provider visits ( p = 0.023), emergency room visits ( p = 0.007), and total days in hospital ( p = 0.015) but lower months since previous eye examination ( P = 0.024). Men had a higher frequency of foot examination than women ( p = 0.028). In T2D adults without HF, unmarried persons had higher days in hospital ( p = 0.009). Participants who performed blood glucose self-monitoring more often had a higher frequency of foot examinations ( p = 0.036). Conclusions: Findings show that HF increases HCU in T2D adults and is higher among those who live alone. Future studies should examine strategies to provide social support on HCU.