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

Chung-Yi Li, Yung-Chung Chuang, Pei-Chun Chen, Michael S. Chen, Miaw-Chwen Lee, Li-Jung Elizabeth Ku and Chiachi Bonnie Lee
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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
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

IJERPH, 2021, vol. 18, issue 4, 1-14

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 (? = ?66.36, p = 0.029; 40.3% of all townships) and ESS (? = ?1.85, p = 0.027; 28.4% of all townships) but positively associated with area deprivation (? = 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.

Keywords: diabetes-related preventable hospitalization; social determinants of health; spatial analysis; Taiwan (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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