The online version of this article (doi:10.1186/1758-5996-6-108) contains supplementary material, which is available to authorized users.
All authors of this study declare that they have no competing interest.
BH, BM and MT were responsible for obtaining the data and creating the cohort. DC and SL designed the study question. DC, SL and RW analyzed the data. CB helped with the interpretation of the analysis. DC wrote the initial draft of the manuscript. SL, RW, BM, MT, CB, BH critically revised the manuscript and contributed significantly to its content. All authors read and approved the final manuscript.
We sought to determine the modifying effects of age and multimorbidity on the association between First Nations status and hospitalizations for diabetes-specific ambulatory care sensitive conditions (ACSC).
We identified 183,654 adults with diabetes from Alberta Canada, and followed them for one year for the outcome of hospitalization or emergency department (ED) visit for a diabetes-specific ACSC. We used logistic regression to determine the association between First Nations status and the outcome, assessing for effect modification by age and multimorbidity with interaction terms. In a model adjusting for age, age2, baseline A1c, duration of diabetes, and multimorbidity, First Nations people were at greater risk than non-First Nations to experience a diabetes-specific hospitalization or ED visit (unadjusted odds ratio [OR] 3.74; 95% confidence interval [CI]: 3.45-4.07). After adjustment for relevant covariates, this association varied by age (interaction: p = 0.018): adjusted OR 3.94 (95% CI: 3.11-4.99) and 5.74 (95% CI: 3.36-9.80) for First Nations compared to non-First Nations at ages 30 and 80 years, respectively.
Compared with non-First Nations, older First Nations patients with diabetes are at greater risk for diabetes-specific hospitalizations. Older First Nations patients with diabetes should be given priority access to primary care services as they are at greatest risk for requiring hospitalization for stabilization of their condition.
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- Age modification of diabetes-related hospitalization among First Nations adults in Alberta, Canada
David JT Campbell
Sarah L Lacny
Robert G Weaver
Braden J Manns
Brenda R Hemmelgarn
- BioMed Central
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