Abstract
BackgroundInformation 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.MethodsUsing 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.ResultsTotal 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).ConclusionVariation 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.
Highlights
Information describing variation in health outcomes for individuals with diabetes related foot disease, across socioeconomic strata is lacking
The findings of this study indicate there is variation between total hospital separations for diabetes related foot disease across socioeconomic strata in Victoria
We have been unable to find any published studies reporting on hospital separations or differences in prevalence or incidence for diabetes related foot disease across Socioeconomic Indexes for Areas (SEIFA) within Australian populations, a limited number of international studies have demonstrated a relationship between socioeconomic determinants and rates of diabetes related foot disease
Summary
Information describing variation in health outcomes for individuals with diabetes related foot disease, across socioeconomic strata is lacking. Inequalities in the overall burden of chronic disease across socioeconomic strata are well documented [1,2]. For those in lower socio-economic strata, disparities exist for both overall disease prevalence and health care outcomes. Information about socio-economic disparities, especially when linked to inequalities in health outcomes, Diabetes related foot disease including peripheral neuropathy, peripheral vascular disease, ulceration and amputation, contribute significantly to the overall burden of disease in Australia [9,10].
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