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- Title
Youth and non‐European ethnicity are associated with increased loss of publicly funded insulin pump access in New Zealand people with type 1 diabetes.
- Authors
Hennessy, Lorelei D.; De Lange, Michel; Wiltshire, Esko J.; Jefferies, Craig; Wheeler, Benjamin J.
- Abstract
Aims: Continuous subcutaneous insulin infusion (CSII) has been publicly funded in New Zealand for people living with type 1 diabetes since 2012. The aim of the current study was to investigate the loss of access, once obtained, to public‐funded CSII. The frequency and socio‐demographics of access, and loss, to CSII spanning the period 2012 to 2018 were examined. Methods: Nationally held data collections including the New Zealand Virtual Diabetes Register were used to calculate the overall and subgroup proportions using and ceasing CSII. A logistic regression model was used to estimate odds ratios for pump use for the predictor variables (sex, age group, ethnicity and deprivation index) and to calculate odds ratios for pump cessation for the same demographic factors. Results: Once CSII access is obtained, approximately 4% per year cease CSII in a subsequent year. This cessation of publicly funded CSII was not distributed equally among the population, showing over‐representation in youth (aged 10–29 years) and non‐Europeans, in particular Māori and Pasifika. Compounding this, it remains less likely for people with diabetes to initially access publicly funded CSII in New Zealand if they are non‐European and more socio‐economically deprived. Conclusions: In New Zealand, Māori and Pasifika, as well as youth, are over‐represented in the cessation of CSII in comparison with Europeans and all other age groups. These groups are also less likely to gain initial access to public funding. Efforts to understand and reduce these disparities are needed, including review of current public funding access criteria.
- Subjects
NEW Zealand; AGE distribution; REPORTING of diseases; ETHNIC groups; HEALTH services accessibility; HEALTH status indicators; INSULIN pumps; TYPE 1 diabetes; PUBLIC welfare; RACE; LOGISTIC regression analysis; SOCIOECONOMIC factors; DESCRIPTIVE statistics; ODDS ratio; ADOLESCENCE
- Publication
Diabetic Medicine, 2021, Vol 38, Issue 1, p1
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.14450