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Israel Journal of Health Policy Research

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01-12-2020 | Care | Original research article

Trends and socioeconomic disparities in diabetes prevalence and quality of care among Israeli children; 2011-2018

Authors: Yiska Loewenberg Weisband, Michal Krieger, Ronit Calderon-Margalit, Orly Manor

Published in: Israel Journal of Health Policy Research | Issue 1/2020

Abstract

Background

Despite Israel’s universal health coverage, disparities in health services provision may still exist. We aimed to assess socioeconomic disparities in diabetes prevalence and quality of care among Israeli children, and to assess whether these changed over time.

Methods

We used repeated cross-sectional analyses in the setting of the National Program for Quality Indicators in Community Healthcare. The data were derived from electronic medical records from Israel’s four health maintenance organizations. The study population included all Israeli children aged 2–17 years in 2011–2018 (2018: N = 2,404,856). Socio-economic position (SEP) was measured using Central Bureau of Statistics data further updated by a private company (Points Business Mapping Ltd), and grouped into 4 categories, ranging from 1 (lowest) to 4 (highest). We used logistic regression to assess the association of SEP with diabetes prevalence, diabetes clinic visits, hemoglobin A1C (HbA1C) testing, and poor glycemic control (HbA1c > 9%), and assessed whether these changed over time.

Results

Diabetes prevalence increased with age and SEP, with a total of 3019 children with diabetes. SEP was positively associated with visiting a specialized diabetes clinic (age and sex adjusted Odds Ratio (aOR_{SEP 4 vs. 1} 2.45, 95% Confidence Interval (CI) 1.67–3.69)). Although children in higher SEPs were less likely to undergo HbA1c testing (aOR_{SEP 4 vs. 1} 0.54, 95% CI 0.40–0.72), they were also less likely to have poor glycemic control (aOR_{SEP 4 vs. 1} 0.25, 95% CI 0.18–0.34). Disparities were especially apparent among children aged 2–9 (6.5% poor glycemic control in SEP 4 vs. 38.2% in SEP 1). Poor glycemic control decreased over time, from 44.0% in 2011 to 34.1% in 2018.

Conclusions

While poor glycemic control rates among children have improved, they remain high compared to rates in adults. Additionally, substantial socioeconomic gaps remain. It is eminent to study the causes of these disparities and develop policies to improve care provided to children in the lower SEP levels, to promote health equity.

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Title: Trends and socioeconomic disparities in diabetes prevalence and quality of care among Israeli children; 2011-2018
Authors: Yiska Loewenberg Weisband
Michal Krieger
Ronit Calderon-Margalit
Orly Manor
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Care
Published in: Israel Journal of Health Policy Research / Issue 1/2020
Electronic ISSN: 2045-4015
DOI: https://doi.org/10.1186/s13584-020-00399-w

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Trends and socioeconomic disparities in diabetes prevalence and quality of care among Israeli children; 2011-2018

Abstract

Background

Methods

Results

Conclusions

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Abstract

Background

Methods

Results

Conclusions

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