Associations of Physician Characteristics with Sex Difference in Ischemic Heart Disease Incidence among Patients Living with Type 2 Diabetes in Taiwan

被引:0
|
作者
Lee, Yung-Hsin [1 ,2 ]
Chang, Ya-Hui [2 ]
Ku, Li-Jung Elizabeth [2 ]
Wu, Jin-Shang [3 ,4 ]
Isfandiari, Muhammad Atoillah [5 ]
Chou, Li-Ping [6 ,7 ]
Li, Chung-Yi [2 ,5 ,8 ,9 ]
机构
[1] Natl Hlth Res Inst, Natl Inst Canc Res, Tainan 704, Taiwan
[2] Natl Cheng Kung Univ, Dept Publ Hlth, Coll Med, Tainan 701, Taiwan
[3] Natl Cheng Kung Univ, Sch Med, Dept Family Med, Coll Med, Tainan 701, Taiwan
[4] Natl Cheng Kung Univ Hosp, Dept Family Med, Tainan 704, Taiwan
[5] Univ Airlangga, Fac Publ Hlth, Dept Epidemiol, Surabaya 60115, Indonesia
[6] Tainan Sin Lau Hosp, Dept Cardiol, Tainan 701, Taiwan
[7] Chang Jung Christian Univ, Dept Hlth Care Adm, Tainan 711, Taiwan
[8] China Med Univ, Dept Publ Hlth, Coll Hlth, Taichung 406, Taiwan
[9] Asia Univ, Dept Healthcare Adm, Coll Med & Hlth Sci, Taichung 413, Taiwan
关键词
diabetes mellitus; cardiovascular diseases; continuity of patient care; medication adherence; physician characteristics;
D O I
10.3390/healthcare9040440
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
(1) Background: Certain non-biological factors are suspected to explain the reduced sex difference in cardiovascular risk after diabetes. This study aimed to assess whether physician characteristics may account for such reduced sex difference. (2) Methods: Totally 10,105 type 2 diabetes patients (including 4962 men and 5143 women) were selected from Taiwan's National Health Insurance claim data. The three-year period following the first day of clinical visit for type 2 diabetes in 2000 was set as the baseline period. The follow-up was made from the first day after baseline period to date of ischemic heart disease (IHD) incidence or censoring. Cox regression model was used to estimate hazard ratios (HRs) of IHD in relation to physician's characteristics. (3) Results: The incidence of IHD for men and women was estimated at 17.47 and 15.96 per 1000 person-years, respectively. After controlling for socio-demographic variables and co-morbidity, male patients experienced a significantly higher HR than females for IHD (1.16, 95% Confidence Interval (CI) 1.04 to 1.29). Further adjustment for treatment adherence/continuity and physician characteristics resulted in essentially the same results. (4) Conclusions: Our study provides little support for the notation that physician characteristics may contribute to the reduced sex difference in IHD incidence in patients with type 2 diabetes.
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页数:15
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