Association of doctor specialty with diabetic patient risk of hospitalization due to diabetic ketoacidosis

A national population-based study in Taiwan

Chih Ching Liu, Kai Ren Chen, Hua Fen Chen, Shiu Li Huang, Chu Chieh Chen, Ming Der Lee, Ming Chung Ko, Chung-Yi Li

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, and its risks can be largely reduced by adequate and high-quality ambulatory diabetic care. The aim of this study is to assess the risk and frequency of developing DKA in relation to the specialty of doctors who provide diabetes cares. Methods In searching for possible episodes of hospitalization due to DKA (ICD-9-CM: 250.1), we used a prospective cohort design in which 500 867 diabetic patients identified in the 1997 National Health Insurance (NHI) ambulatory care data set of Taiwan were linked to the 1997-2006 NHI inpatient claims data. The study subjects were categorized into four groups according to doctor specialty. A logistic regression model was used to assess the risk and frequency of DKA admission in relation to doctor's specialty. Results Compared with the patients routinely cared by endocrinologists, those not consistently cared by endocrinologists had significantly increased odds ratios (ORs) of DKA admission, ranging between 1.51 and 2.12. Moreover, the adjusted OR of the higher DKA admission frequency (≥0.133 times/person-year) for the patients not regularly cared by endocrinologists was also significantly increased, between 4.45 and 6.93. Conclusions Doctor specialty significantly influenced the risk and frequency of DKA admission in diabetes patients in Taiwan. Local health care administrators and policy makers should therefore consider promoting the quality of diabetes care provided by non- endocrinologists.

Original languageEnglish
Pages (from-to)150-155
Number of pages6
JournalJournal of Evaluation in Clinical Practice
Volume17
Issue number1
DOIs
Publication statusPublished - 2011 Feb 1

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Diabetic Ketoacidosis
Taiwan
Hospitalization
Population
National Health Programs
Ambulatory Care
Administrative Personnel
Logistic Models
Odds Ratio
Quality of Health Care
International Classification of Diseases
Diabetes Complications
Health Policy
Inpatients
Delivery of Health Care
Endocrinologists

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Liu, Chih Ching ; Chen, Kai Ren ; Chen, Hua Fen ; Huang, Shiu Li ; Chen, Chu Chieh ; Lee, Ming Der ; Ko, Ming Chung ; Li, Chung-Yi. / Association of doctor specialty with diabetic patient risk of hospitalization due to diabetic ketoacidosis : A national population-based study in Taiwan. In: Journal of Evaluation in Clinical Practice. 2011 ; Vol. 17, No. 1. pp. 150-155.
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abstract = "Objectives Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, and its risks can be largely reduced by adequate and high-quality ambulatory diabetic care. The aim of this study is to assess the risk and frequency of developing DKA in relation to the specialty of doctors who provide diabetes cares. Methods In searching for possible episodes of hospitalization due to DKA (ICD-9-CM: 250.1), we used a prospective cohort design in which 500 867 diabetic patients identified in the 1997 National Health Insurance (NHI) ambulatory care data set of Taiwan were linked to the 1997-2006 NHI inpatient claims data. The study subjects were categorized into four groups according to doctor specialty. A logistic regression model was used to assess the risk and frequency of DKA admission in relation to doctor's specialty. Results Compared with the patients routinely cared by endocrinologists, those not consistently cared by endocrinologists had significantly increased odds ratios (ORs) of DKA admission, ranging between 1.51 and 2.12. Moreover, the adjusted OR of the higher DKA admission frequency (≥0.133 times/person-year) for the patients not regularly cared by endocrinologists was also significantly increased, between 4.45 and 6.93. Conclusions Doctor specialty significantly influenced the risk and frequency of DKA admission in diabetes patients in Taiwan. Local health care administrators and policy makers should therefore consider promoting the quality of diabetes care provided by non- endocrinologists.",
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Association of doctor specialty with diabetic patient risk of hospitalization due to diabetic ketoacidosis : A national population-based study in Taiwan. / Liu, Chih Ching; Chen, Kai Ren; Chen, Hua Fen; Huang, Shiu Li; Chen, Chu Chieh; Lee, Ming Der; Ko, Ming Chung; Li, Chung-Yi.

In: Journal of Evaluation in Clinical Practice, Vol. 17, No. 1, 01.02.2011, p. 150-155.

Research output: Contribution to journalArticle

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T1 - Association of doctor specialty with diabetic patient risk of hospitalization due to diabetic ketoacidosis

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AU - Liu, Chih Ching

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AU - Huang, Shiu Li

AU - Chen, Chu Chieh

AU - Lee, Ming Der

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AU - Li, Chung-Yi

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N2 - Objectives Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, and its risks can be largely reduced by adequate and high-quality ambulatory diabetic care. The aim of this study is to assess the risk and frequency of developing DKA in relation to the specialty of doctors who provide diabetes cares. Methods In searching for possible episodes of hospitalization due to DKA (ICD-9-CM: 250.1), we used a prospective cohort design in which 500 867 diabetic patients identified in the 1997 National Health Insurance (NHI) ambulatory care data set of Taiwan were linked to the 1997-2006 NHI inpatient claims data. The study subjects were categorized into four groups according to doctor specialty. A logistic regression model was used to assess the risk and frequency of DKA admission in relation to doctor's specialty. Results Compared with the patients routinely cared by endocrinologists, those not consistently cared by endocrinologists had significantly increased odds ratios (ORs) of DKA admission, ranging between 1.51 and 2.12. Moreover, the adjusted OR of the higher DKA admission frequency (≥0.133 times/person-year) for the patients not regularly cared by endocrinologists was also significantly increased, between 4.45 and 6.93. Conclusions Doctor specialty significantly influenced the risk and frequency of DKA admission in diabetes patients in Taiwan. Local health care administrators and policy makers should therefore consider promoting the quality of diabetes care provided by non- endocrinologists.

AB - Objectives Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus, and its risks can be largely reduced by adequate and high-quality ambulatory diabetic care. The aim of this study is to assess the risk and frequency of developing DKA in relation to the specialty of doctors who provide diabetes cares. Methods In searching for possible episodes of hospitalization due to DKA (ICD-9-CM: 250.1), we used a prospective cohort design in which 500 867 diabetic patients identified in the 1997 National Health Insurance (NHI) ambulatory care data set of Taiwan were linked to the 1997-2006 NHI inpatient claims data. The study subjects were categorized into four groups according to doctor specialty. A logistic regression model was used to assess the risk and frequency of DKA admission in relation to doctor's specialty. Results Compared with the patients routinely cared by endocrinologists, those not consistently cared by endocrinologists had significantly increased odds ratios (ORs) of DKA admission, ranging between 1.51 and 2.12. Moreover, the adjusted OR of the higher DKA admission frequency (≥0.133 times/person-year) for the patients not regularly cared by endocrinologists was also significantly increased, between 4.45 and 6.93. Conclusions Doctor specialty significantly influenced the risk and frequency of DKA admission in diabetes patients in Taiwan. Local health care administrators and policy makers should therefore consider promoting the quality of diabetes care provided by non- endocrinologists.

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