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Disentangling the influence of living place and socioeconomic position on health services use among diabetes patients: A population-based study

Author

Listed:
  • Sébastien Lamy
  • Denis Ducros
  • Chloé Diméglio
  • Hélène Colineaux
  • Romain Fantin
  • Eloïse Berger
  • Pascale Grosclaude
  • Cyrille Delpierre
  • Béatrice Bouhanick

Abstract

This research investigates the influence of place of residence and diabetic patient’s socioeconomic position on their use of health services in a universal health care system. This retrospective cross-sectional population-based study is based on the joint use of the Health Insurance information systems, an ecological indicator of social deprivation and an indicator of potential spatial accessibility of healthcare provision in the Midi-Pyrénées region. Using French healthcare insurance population-based data on reimbursement of out-of-hospital care during the year 2012, we study the use of health services among patients aged 50 and over (n = 90,136).We built logistic regression models linking health services use to socioeconomic position by geographic area, adjusted for age, gender, healthcare provision, information regarding patients precariousness, and long-term condition, used as proxy for the state of health. After adjustment for healthcare provision, the lower population density in the geographical area of concern, the lower the access to specialised care, independent of the patients’ SEP. General practitioner attendance was higher among the patients with the lowest SEP without being clearly influenced by their living place. We found no clear influence of either patients’ SEP or their living place on their access to biological follow-up. This study is an attempt to account for the geographical context and to go further in studying the social determinants of health among diabetes patients.

Suggested Citation

  • Sébastien Lamy & Denis Ducros & Chloé Diméglio & Hélène Colineaux & Romain Fantin & Eloïse Berger & Pascale Grosclaude & Cyrille Delpierre & Béatrice Bouhanick, 2017. "Disentangling the influence of living place and socioeconomic position on health services use among diabetes patients: A population-based study," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-14, November.
    • Handle: RePEc:plo:pone00:0188295
    DOI: 10.1371/journal.pone.0188295
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    References listed on IDEAS

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    1. Aletta Dijkstra & Fanny Janssen & Marinus De Bakker & Jens Bos & René Lub & Leo J G Van Wissen & Eelko Hak, 2013. "Using Spatial Analysis to Predict Health Care Use at the Local Level: A Case Study of Type 2 Diabetes Medication Use and Its Association with Demographic Change and Socioeconomic Status," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-9, August.
    2. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    3. Camilla Sortsø & Jørgen Lauridsen & Martha Emneus & Anders Green & Peter Bjødstrup Jensen, 2017. "Socioeconomic inequality of diabetes patients’ health care utilization in Denmark," Health Economics Review, Springer, vol. 7(1), pages 1-22, December.
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    1. Rodríguez-Sánchez, Beatriz & Cantarero-Prieto, David, 2019. "Socioeconomic differences in the associations between diabetes and hospital admission and mortality among older adults in Europe," Economics & Human Biology, Elsevier, vol. 33(C), pages 89-100.

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