Avoidable hospitalisation for diabetes mellitus among immigrants and natives: Results from the Italian Network for Longitudinal Metropolitan Studies

Zuanna, Teresa Dalla; Cacciani, Laura; Barbieri, Giulia; Ferracin, Elisa; Zengarini, Nicolás; Girolamo, Chiara Di; Caranci, Nicola; Petrelli, Alessio; Marino, Claudia; Agabiti, Nera; Canova, Cristina

doi:10.1016/j.numecd.2020.05.006

Cited by 8 publications

(9 citation statements)

References 39 publications

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“…Second, we find no difference in the incidence of chronic AHs between Italians and documented immigrants, at least partially supported by an Italian study comparing AH for diabetes mellitus in immigrants and natives, which found significant differences in AH only for immigrant males. 22 We interpret the latter result as evidence that for those chronic conditions that last over time and require ongoing medical attention, informational barriers to access are less relevant, and the incidence of AHs does not differ between Italians and documented immigrants, who can fully access the SSN. In apparent support of this, a Canadian study where researchers were able to link a national community health survey with demographic and risk factor information with hospital discharge records to determine times to AHs for chronic conditions, found that immigrant status lowered the risk of AHs and stressed the importance of prevention in combating AH for chronic conditions.…”

Section: Discussionmentioning

confidence: 85%

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Avoidable hospitalizations and access to primary care: comparisons among Italians, resident immigrants and undocumented immigrants in administrative hospital discharge records

2022

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Section: Discussionmentioning

confidence: 85%

“… 13 , 18 , 19 In the European context, evidence on immigrants’ AH rates is relatively recent 18 and in general shows that immigrants experience a higher risk of AHs, although results differ by country, reason to migrate and illness. 20 , 21 , 22 …”

Section: Introductionmentioning

confidence: 99%

Avoidable hospitalizations and access to primary care: comparisons among Italians, resident immigrants and undocumented immigrants in administrative hospital discharge records

2022

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“…However, a study of the Italian Network of Longitudinal Metropolitan Studies, a multicentre and multipurpose pool of metropolitan population cohorts enrolled in nine Italian cities not including Milan, found that AH rates for diabetes mellitus of adults from high migratory pressure countries had higher AH rates compared with Italians in every city, with the exception of Rome. 39 This suggests that heterogeneity of findings may occur even within the same country and local context is very important.…”

Section: Discussionmentioning

confidence: 99%

Inequalities in avoidable hospitalisation in large urban areas: retrospective observational study in the metropolitan area of Milan

2020

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ObjectiveSignificant inequalities in access to healthcare system exist between residents of world megacities, even if they have different healthcare systems. The aim of this study was to estimate avoidable hospitalisations in the metropolitan area of Milan (Italy) and explore inequalities in access to healthcare between patients and across their areas of residence.DesignRetrospective observational study.SettingPublic and accredited private hospitals in the metropolitan area of Milan. Data obtained from the hospital discharge database of the Italian Health Ministry.Participants472 579 patients hospitalised for ambulatory care sensitive conditions and resident in the metropolitan area of Milan from 2005 to 2016.Outcome measureAge-adjusted rates of avoidable hospitalisations; OR for hospital admissions with ambulatory care sensitive conditions.MethodsAge-adjusted rates of avoidable hospitalisations in the metropolitan area of Milan were estimated from 2005 to 2016 using direct standardisation. For the hospitalised population, multilevel logistic regression model with patient random effects was used to identify patients, hospitals and municipalities’ characteristics associated with risk of avoidable hospitalisation in the period 2012–2016.ResultsThe rate of avoidable hospitalisation in Milan fell steadily between 2005 and 2016 from 16.6 to 10.5 per 1000. Among the hospitalised population, the odds of being hospitalised with an ambulatory care sensitive condition was higher for male (OR 1.42, 95% CI 1.36 to 1.48), older (OR 1.012, 95% CI 1.01 to 1.014), low-educated (elementary school vs degree OR 4.23, 95% CI 3.72 to 4.81) and single (vs married OR 2.08, 95% CI 2.01 to 2.16) patients with comorbidities (OR 1.47, 95% CI 1.38 to 1.56); avoidable admissions were more frequent in public non-teaching hospitals while municipality’s characteristics did not appear to be correlated with hospitalisation for ambulatory care sensitive conditions.ConclusionsThe health system in metropolitan Milan has experienced a reduction in avoidable hospitalisations between 2005 and 2016, quite homogeneously across its 134 municipalities. The study design allowed to explore inequalities among the hospitalised population for which we found specific sociodemographic disadvantages.

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“…Unemployment increases and lower income also makes access to medical care more difficult, particularly among the most fragile population groups, including migrants [7]. Adult male immigrants are at higher risk of experiencing avoidable hospitalization for diabetes than Italians, with differences by area of origin, suggesting that they may experience lower access to and lower quality of primary care for diabetes [8].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Culturally Tailored Dietary Intervention in the North African and Bangladeshi Diabetic Patients in Italy

Piombo¹,

Nicolella²,

Barbarossa³

et al. 2020

IJERPH

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Immigrants show higher adjusted diabetes prevalence than Italians, especially among South-East Asians followed by North and Sub-Saharan Africans. Diabetes progression is influenced by food behaviors, and diet control is a critical aspect in disease management. Food habits have many cultural and symbolic implications. Guidelines recommend that every patient should receive appropriate self-management education according to cultural and socioeconomic characteristics. This study aims to test whether a customized diet and transcultural mediator’s support can improve immigrants’ food habits. A pre-post quali-quantitative study was conducted among 20–79-year-old Bangladeshi and North African diabetic immigrants. The INMP transcultural mediator, an expert in the social and health care field, actively participates in clinical activity by decoding linguistic and cultural needs expressed by the foreigner patient. Five culturally tailored dietary profiles were designed according to international diabetes guidelines and adjusted to traditional food habits. Data were collected with two different semi-structured questionnaires. Changes in food consumption were assessed through McNemar’s test, while paired Wilcoxon Signed-Rank test was used to analyze pre and post intervention. Fifty-five patients were enrolled. At follow-up, cereals, meat, and potatoes intake significantly improved, and the number of adequate dietary habits for each patient increased significantly. Transcultural mediator support was 90% positively evaluated. Adherence to dietary control is favorably influenced by a transcultural intervention, which is based on clinical and socio-cultural criteria, in compliance with patient’s lifestyles.

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Avoidable hospitalisation for diabetes mellitus among immigrants and natives: Results from the Italian Network for Longitudinal Metropolitan Studies

Cited by 8 publications

References 39 publications

Avoidable hospitalizations and access to primary care: comparisons among Italians, resident immigrants and undocumented immigrants in administrative hospital discharge records

Avoidable hospitalizations and access to primary care: comparisons among Italians, resident immigrants and undocumented immigrants in administrative hospital discharge records

Inequalities in avoidable hospitalisation in large urban areas: retrospective observational study in the metropolitan area of Milan

Outcomes of Culturally Tailored Dietary Intervention in the North African and Bangladeshi Diabetic Patients in Italy

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