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, Chiachi Bonnie Lee

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Article number2146
Pages (from-to)1-15
Number of pages15
JournalInternational journal of environmental research and public health
Issue number4
Publication statusPublished - 2021 Feb 2

All Science Journal Classification (ASJC) codes

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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