Factors affecting screening for diabetic complications in the community: a multilevel analysis

Abstract

OBJECTIVES:The objective of the present study was to identify the factors that affect screening for diabetic complications by sex in the community.METHODS:This study used individual-level data from the 2013 Community Health Survey (CHS) for 20,806 (male, 9,958; female, 10,848) adults aged 30 years or older who were diagnosed with diabetes. Community-level data for 253 communities were derived from either CHS or national statistics. A chi-square test and multilevel logistic regression analysis was performed.RESULTS:There were significant differences in the rate of screening for diabetic complications according to individual-level and community-level variables. In the multilevel analysis, the community-level variance ratio of the null model was 7.4% and 9.2% for males and females, respectively. With regard to community-level variables, males were affected by the city type, number of physicians, and their living environment, while females were affected by number of physicians, natural and living environments, and public transportation.CONCLUSIONS:The factors that influenced individual willingness to undergo screening for diabetic complications differed slightly by sex; however, both males and females were more likely to undergo screening when they recognized their health status as poor or when they actively sought to manage their health conditions. Moreover, in terms of community-level variables, both males and females were affected by the number of physicians. It is essential to provide sufficient and ongoing opportunities for education on diabetes and its management through collaboration with local communities and primary care medical centers.

Effects of Diabetes Quality Assessment on Diabetes Management Behaviors Based on a Nationwide Survey

“…In a previous study that used 2013 KCHS data [ 24 ], the number of internists per 1000 inhabitants was positively related to undergoing a fundus examination or microalbuminuria test (OR 1.26, 95% CI 1.01–1.57), and this effect size was smaller than that in our study. The heterogeneity among districts explained by the district-level variable was greater in our study than in the previous study.…”

Factors Influencing the Utilization of Diabetes Complication Tests Under the COVID-19 Pandemic: Machine Learning Approach

“…The results of this study showed that diabetic patients who responded that their subjective health were moderate or poor utilized both the fundus examination and microprotein urination more than those who indicated that their subjective health were good. Previous studies also confirmed this result ( 10 , 11 , 13 , 15 ). It could be because when people judged themselves healthier, their positive thoughts had a negative correlation with preventive health behaviors such as regular health checkups ( 11 , 15 ).…”

“…Previous studies also confirmed this result ( 10 , 11 , 13 , 15 ). It could be because when people judged themselves healthier, their positive thoughts had a negative correlation with preventive health behaviors such as regular health checkups ( 11 , 15 ). Therefore, it is needed that the primary medical care should provide regular notice and education about regular complication examination for diabetic patients who believe that they are in good health and monitor whether they utilize complication screening continuously.…”

“…Many previous studies (10)(11)(12)(13) indicated the disease duration of diabetes, age, education level, residential area, income level, diabetes education, and subjective health status were factors associated with the fundus examination of diabetic patients. Moreover, other studies reported that sex, age, hospitalization experience, and comorbidities were related to receiving using the glycated hemoglobin test (14,15). However, there are still not enough studies on the prediction of non-utilization of a complication test or a glycated hemoglobin test for preventing diabetes complications by using large-scale community-based big data.…”

Five-year Trajectory about Screening for Complication of Diabetes Kidney Disease and Cardiovascular Disease Mortality : Focusing on Regional Difference

“…It is a disease that requires not only drug treatment but also self-management. Due to the aging of the population and the development of diagnostic and treatment technologies, the timing of diabetes diagnosis is accelerating, and the period to manage diabetes is lengthening, making it essential to develop more active self-management habits [35,36]. The subject of disease management is the patient.…”