Healthcare use among people with diabetes mellitus in Europe: a population-based cross-sectional study

Abstract

Objective This study aimed to determine the association of health determinants, lifestyle and socioeconomic variables on healthcare use in people with diabetes in Europe. Design A cross-sectional study was conducted using data from the European Health Interview Survey wave 2 (ie, secondary analysis). Setting The sample included data from 25 European countries. Participants The sample included 16 270 patients with diabetes aged 15 years or older (49.1% men and 50.9%women). Results The survey data showed that 58.2% of respondents had seen their primary care physician in the past month and 22.6% had been admitted to the hospital in the past year. Use of primary care was associated with being retired (prevalence ratio (PR) 1.13, 95%CI 1.07 to 1.19) and having very poor self-perceived health (PR 1.80, 95%CI 1.51 to 2.15), long-standing health problems (PR 1.14, 95%CI 1.04 to 1.24), high blood pressure (PR 1.06, 95%CI 1.03 to 1.10) and chronic back pain (PR 1.07, 95%CI 1.04 to 1.11). Hospital admission was associated with very poor self-perceived health (PR 3.03, 95%CI 2.14 to 4.31), accidents at home (PR 1.54, 95%CI 1.40 to 1.69), chronic obstructive pulmonary disease (COPD) (PR 1.34, 95%CI 1.22 to 1.47), high blood pressure (PR 1.08, 95%CI 1.01 to 1.17), chronic back pain (PR 0.91, 95%CI 0.84 to 0.98), moderate difficulty walking (PR 1.33, 95%CI 1.21 to 1.45) and severe difficulty walking (PR 1.67, 95%CI 1.51 to 1.85). Conclusions In the European diabetic population, the high cumulative incidences of primary care visits and hospital admissions are associated with labour status, alcohol consumption, self-perceived health, long-standing health problems, high blood pressure, chronic back pain, accidents at home, COPD and difficulty walking.