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Social Determinants of Diabetes-Related Preventable Hospitalization in Taiwan: A Spatial Analysis

Author

Listed:
  • Chung-Yi Li

    (Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan)

  • Yung-Chung Chuang

    (Department of Urban Planning and Spatial Information, Feng Chia University, Taichung 407802, Taiwan)

  • Pei-Chun Chen

    (Department of Public Health, China Medical University, Taichung 40402, Taiwan)

  • Michael S. Chen

    (Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
    Department of Social Welfare and Center for Innovative Research on Aging Society, National Chung Cheng University, Chiayi 62102, Taiwan)

  • Miaw-Chwen Lee

    (Department of Social Welfare and Center for Innovative Research on Aging Society, National Chung Cheng University, Chiayi 62102, Taiwan)

  • Li-Jung Elizabeth Ku

    (Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan)

  • Chiachi Bonnie Lee

    (Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan)

Abstract

Diabetes-Related Preventable Hospitalization (DRPH) has been identified as an important indicator of efficiency and quality of the health system and can be modified by social determinants. However, the spatial disparities, clustering, and relationships between DRPH and social determinants have rarely been investigated. Accordingly, this study examined the association of DRPH with area deprivation, densities of certificated diabetes health-promoting clinics (DHPC) and hospitals (DHPH), and the presence of elderly social services (ESS) using both statistical and spatial analyses. Data were obtained from the 2010–2016 National Health Insurance Research Database (NHIRD) and government open data. Township-level ordinary least squares (OSL) and geographically weighted regression (GWR) were conducted. DRPH rates were found to be negatively associated with densities of DHPC (β = −66.36, p = 0.029; 40.3% of all townships) and ESS (β = −1.85, p = 0.027; 28.4% of all townships) but positively associated with area deprivation (β = 2.96, p = 0.002; 25.6% of all townships) in both OLS and GWR models. Significant relationships were found in varying areas in the GWR model. DRPH rates are high in townships of Taiwan that have lower DHPC densities, lower ESS densities, and greater socioeconomic deprivation. Spatial analysis could identify areas of concern for potential intervention.

Suggested Citation

  • Chung-Yi Li & Yung-Chung Chuang & Pei-Chun Chen & Michael S. Chen & Miaw-Chwen Lee & Li-Jung Elizabeth Ku & Chiachi Bonnie Lee, 2021. "Social Determinants of Diabetes-Related Preventable Hospitalization in Taiwan: A Spatial Analysis," IJERPH, MDPI, vol. 18(4), pages 1-14, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:2146-:d:503870
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    References listed on IDEAS

    as
    1. Yoshitaka Nishino & Stuart Gilmour & Kenji Shibuya, 2015. "Inequality in Diabetes-Related Hospital Admissions in England by Socioeconomic Deprivation and Ethnicity: Facility-Based Cross-Sectional Analysis," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-15, February.
    2. Xueqian Song & Yongping Wei & Wei Deng & Shaoyao Zhang & Peng Zhou & Ying Liu & Jiangjun Wan, 2019. "Spatio-Temporal Distribution, Spillover Effects and Influences of China’s Two Levels of Public Healthcare Resources," IJERPH, MDPI, vol. 16(4), pages 1-18, February.
    3. Hsin-Ling Yeh & Shang-Wei Hsu & Yu-Chia Chang & Ta-Chien Chan & Hui-Chen Tsou & Yen-Chen Chang & Po-Huang Chiang, 2017. "Spatial Analysis of Ambient PM 2.5 Exposure and Bladder Cancer Mortality in Taiwan," IJERPH, MDPI, vol. 14(5), pages 1-14, May.
    4. Tashi Dendup & Xiaoqi Feng & Stephanie Clingan & Thomas Astell-Burt, 2018. "Environmental Risk Factors for Developing Type 2 Diabetes Mellitus: A Systematic Review," IJERPH, MDPI, vol. 15(1), pages 1-25, January.
    5. Wei‐Hua Tian, 2019. "Investigating unmet health care needs under the National Health Insurance program in Taiwan: A latent class analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(2), pages 572-582, April.
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    Cited by:

    1. Tsai, Wen-Chen & Huang, Kuang-Hua & Chen, Pei-Chun & Chang, Yu-Chia & Chen, Michael S. & Lee, Chiachi Bonnie, 2023. "Effects of individual and neighborhood social risks on diabetes pay-for-performance program under a single-payer health system," Social Science & Medicine, Elsevier, vol. 326(C).

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