{"title":"日本收入/就业状况与糖尿病护理过程、健康行为和健康结果之间的关系:利用与问卷调查相关联的索赔数据进行的横断面研究","authors":"Takuya Yamaoka, Takehiro Sugiyama, Noriko Ihana-Sugiyama, Akiko Kimura, Kouko Yamamoto, Kenjiro Imai, Naoaki Kuroda, Mitsuru Ohsugi, Kohjiro Ueki, Toshimasa Yamauchi, Nanako Tamiya","doi":"10.1111/jdi.14301","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims/Introduction</h3>\n \n <p>We aimed to explore the associations between income/employment status and diabetes care processes, health behaviors and health outcomes.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>This cross-sectional study used health insurance claims data between April 2021 and March 2022, and a questionnaire survey between December 2022 and January 2023 in Tsukuba City. The study analyzed the participants with diabetes (other than type 1) from those selected by stratified random sampling. We evaluated diabetes care processes, health behaviors and health outcomes by calculating weighted proportions among the groups. We also assessed the associations between income/employment status and these variables using multivariable modified Poisson regression models.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of the 264 identified participants, 161 (64.2%) were men and 168 (72.8%) were aged ≥65 years old. Compared with the low-income groups, the high-income group had a higher proportion of sodium–glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists use (adjusted risk ratio [aRR] 1.70, 95% confidence interval (CI) 1.07–2.72), a higher proportion of attendance to annual health checkups for ≥2 years (aRR 1.68, 95% CI 1.07–2.64) and a lower proportion of all-cause hospitalization (aRR 0.15, 95% CI 0.04–0.48); additionally, the middle-income group had a lower proportion of high total outpatient medical expenses (aRR 0.57, 95% CI 0.35–0.92). Compared to the no work time group, the full-time work group had a lower proportion of exercise habits (aRR 0.59, 95% CI 0.35–0.99) and a higher proportion of good self-reported health (aRR 2.08, 95% CI 1.22–3.55).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Several variables were associated with income/employment status. Policy intervention should focus on high-risk groups identified by considering these associations.</p>\n </section>\n </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14301","citationCount":"0","resultStr":"{\"title\":\"Associations between income/employment status and diabetes care processes, health behaviors, and health outcomes in Japan: A cross-sectional study using claims data linked to a questionnaire survey\",\"authors\":\"Takuya Yamaoka, Takehiro Sugiyama, Noriko Ihana-Sugiyama, Akiko Kimura, Kouko Yamamoto, Kenjiro Imai, Naoaki Kuroda, Mitsuru Ohsugi, Kohjiro Ueki, Toshimasa Yamauchi, Nanako Tamiya\",\"doi\":\"10.1111/jdi.14301\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims/Introduction</h3>\\n \\n <p>We aimed to explore the associations between income/employment status and diabetes care processes, health behaviors and health outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Materials and Methods</h3>\\n \\n <p>This cross-sectional study used health insurance claims data between April 2021 and March 2022, and a questionnaire survey between December 2022 and January 2023 in Tsukuba City. The study analyzed the participants with diabetes (other than type 1) from those selected by stratified random sampling. We evaluated diabetes care processes, health behaviors and health outcomes by calculating weighted proportions among the groups. We also assessed the associations between income/employment status and these variables using multivariable modified Poisson regression models.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of the 264 identified participants, 161 (64.2%) were men and 168 (72.8%) were aged ≥65 years old. Compared with the low-income groups, the high-income group had a higher proportion of sodium–glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists use (adjusted risk ratio [aRR] 1.70, 95% confidence interval (CI) 1.07–2.72), a higher proportion of attendance to annual health checkups for ≥2 years (aRR 1.68, 95% CI 1.07–2.64) and a lower proportion of all-cause hospitalization (aRR 0.15, 95% CI 0.04–0.48); additionally, the middle-income group had a lower proportion of high total outpatient medical expenses (aRR 0.57, 95% CI 0.35–0.92). Compared to the no work time group, the full-time work group had a lower proportion of exercise habits (aRR 0.59, 95% CI 0.35–0.99) and a higher proportion of good self-reported health (aRR 2.08, 95% CI 1.22–3.55).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Several variables were associated with income/employment status. Policy intervention should focus on high-risk groups identified by considering these associations.</p>\\n </section>\\n </div>\",\"PeriodicalId\":51250,\"journal\":{\"name\":\"Journal of Diabetes Investigation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14301\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Diabetes Investigation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jdi.14301\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Diabetes Investigation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jdi.14301","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Associations between income/employment status and diabetes care processes, health behaviors, and health outcomes in Japan: A cross-sectional study using claims data linked to a questionnaire survey
Aims/Introduction
We aimed to explore the associations between income/employment status and diabetes care processes, health behaviors and health outcomes.
Materials and Methods
This cross-sectional study used health insurance claims data between April 2021 and March 2022, and a questionnaire survey between December 2022 and January 2023 in Tsukuba City. The study analyzed the participants with diabetes (other than type 1) from those selected by stratified random sampling. We evaluated diabetes care processes, health behaviors and health outcomes by calculating weighted proportions among the groups. We also assessed the associations between income/employment status and these variables using multivariable modified Poisson regression models.
Results
Of the 264 identified participants, 161 (64.2%) were men and 168 (72.8%) were aged ≥65 years old. Compared with the low-income groups, the high-income group had a higher proportion of sodium–glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists use (adjusted risk ratio [aRR] 1.70, 95% confidence interval (CI) 1.07–2.72), a higher proportion of attendance to annual health checkups for ≥2 years (aRR 1.68, 95% CI 1.07–2.64) and a lower proportion of all-cause hospitalization (aRR 0.15, 95% CI 0.04–0.48); additionally, the middle-income group had a lower proportion of high total outpatient medical expenses (aRR 0.57, 95% CI 0.35–0.92). Compared to the no work time group, the full-time work group had a lower proportion of exercise habits (aRR 0.59, 95% CI 0.35–0.99) and a higher proportion of good self-reported health (aRR 2.08, 95% CI 1.22–3.55).
Conclusions
Several variables were associated with income/employment status. Policy intervention should focus on high-risk groups identified by considering these associations.
期刊介绍:
Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).