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Table 3 Description of the final model including diabetes-related hospitalisation predictor variables, other than primary health care resourcing

From: A systematic review of evidence on the association between hospitalisation for chronic disease related ambulatory care sensitive conditions and primary health care resourcing

First author and date published (country) Type of analysis (reporting of results) Study design (date) Health risks and socio-economic factorsasignificantly associated with an increase [↑] or decrease [↓] in hospitalisationb(level of variable) Independent variables that were not significantcor reference (level of variable) Variance explained by the model (r-squared)
Dusheiko 2011 (England) Negative binomial regression (incident rate ratio) Prospective open cohort (2001/02 to 2006/07) % HbA1c ≤7.4/7.5 (f) [↓] % 7.4/7.5 < HbA1c ≤10 (f) [↓] % HbA1c monitored (f) [↑] Baseline hospitalisation rate (f) [↑] Average physician age (f) [↓] % non-principal [↓]physicians (f) Training practice (f) [↑] % females 15–44 & 75+ years (f) [↑] Diabetes prevalence (f) [↑] Mental health prevalence (f) [↑] Heart disease prevalence (f) [↓] COPD prevalence (f) [↑] Low income index (f) [↑] % smoking (c) [↑] % obese (c) [↑] % communal residents (c) [↓] Located urban sparse, village/hamlet, village/hamlet sparse [↓] Mean distance to nearest practice (c)[↑] Practice population (f) Personal medical services contract practice(f) % female physicians (f) % UK qualified physicians (f) % males all age groups (f) % females by age group other than age 15–44 & 75+ years(f) % non-white (c) % incapacity benefit (c) % binge drinking (c)Education/qualification deprivation (c) Central heating deprivation (c) Crime (c) Urban location (ref) Located town and fringe and fringe sparse (f) Mean distance to nearest 5 hospitals (f) Efron’s R2 = 0.206
Griffiths 2010 (England) [outcome is ≥ 1 or ≥ 2 diabetes admissions] Two-level multilevel model with GP practices nested within Primary Care Trusts (hospitalisation rate from count of admissions) Cross sectional (2005/06) Index of deprivation (f) [↑] % aged ≥65 years (f) [↓] % ethnic minority (f) [↓] Least deprived (ref) Density (people per hectare) (f) GP ≥45 years (f) % female GPs (f) % GP qualified in UK (f) Not reported
[outcome is standardised diabetes admission ratio] As above As above Density (people per hectare) (f) [↑] Unadjusted T2DM prevalence (f) [↑] % female GP (f) [↓] % GPs UK qualified (f) [↓] % ethnic minority (f) GP ≥45 years (f) Not reported
Lavoie 2010 (Canada) Generalised estimating equations (average difference in ACSC hospitalisation rates among different facility types) Prospective open cohort (1984/85–2004/05) Age group (f) [result not reported] Gender (f) [result not reported] Location (f) [result not reported] Unknown Not reported
Ng 2010 (Canada) Multi-variate logistic regression (odds ratio) Prospective cohort (2000/01 –2002/03) Age ≥ 65 years (i) [↑] Female (i) [↓] Lower to middle household income (i) [↑] Health utility indexd (i) [↓] Other chronic conditions (i) [↑] Prior hospitalisations (i) [↑] Impact of health problems experienced often or sometimes (i) [↑] Physically inactive (i) [↑] Former or current smoker (i) [↑] Regular alcohol consumption (i) [↓] Current insulin use (i) [↑] ≥ 1 specialist consultations in past 12 months (i) [↑] Residing in high hospital use health region (i) [↑] Age 12–44 years (ref) Age 45–64 years (i) Male (ref) Highest income (ref) Lower, middle, upper middle (based on quintiles) household income (i) Residence urban or rural (i) No other chronic conditions except diabetes (ref) No prior hospitalisation (ref), Impact of health problems never experienced (ref) Physically active (ref) Moderately active (i) Never smoked (ref) Occasional alcohol consumption (ref) Former or never consumed alcohol (i) Not currently on insulin (ref) Body mass index (i) Daily fruit and vegetable consumption (i) Unmet health care needs (i) Not reported
Lin 2010 (Taiwan) [outcome is short-term diabetes ACSC] Cox proportional hazard regression (relative risk of hospitalisation) Prospective cohort (1997–2002) New patient (i) [↓] Age (i) [↓] Age ≥60.5 years (i) [↑] Existing patients (ref) Age <60.5 years (ref) Number of comorbidities (i) Medium continuity of care (i) Low continuity of care (i) Male (i) Not reported
[outcome is long-term diabetes ACSC] As above As above Medium (i) [↑] and low continuity of care (i) [↑] relative to high New patient (i) [↓] Age ≥60.5 years [↑] High continuity (ref) Age (i) Number of comorbidities (i) Male Not reported
Bruni 2009 (Italy) Multi-level logit model (probability of being hospitalised) Cross sectional (2003) Age 65–75 years (i) [↓] Age >75 years (i) [↑] Insulin dependence (i) [↑] Male GP gender (i) [↑] Age 35–65 years (ref) Gender (i) No insulin (ref) GP female (ref) GP age (i) Practice location rural (i) GP postgraduate qualifications (i) % diabetic patients (i) Endocrinology beds (d) Not reported
El-Din 2009 (Saudi Arabia) Stepwise logistic regression (odds of being hospitalised) Case control Gender (i) [↑] Presence of nephropathy (i) [↑] HbA1c ≥ 7 mmol/L (i) [↑] Female (ref) Nephropathy not present (ref) HbA1c <7 mmol/l (ref) Not reported
Rizza 2007 (Italy) Multi-variate logistic regression (odds ratio) Cross sectional (April–July 2005) Number hospitalisations previous year (i) [↑] Education level (i) Length of hospital stay (i) Self-reported health status (i) Sex (i)Age (i) Not reported
Gulliford 2004 (England) Multiple linear regression (chronic hospital admissions per 100 000 persons) Cross sectional (1999) % rural patients (ha) [↓] % GPs ≥ 61 years (ha) [↑] % practices with female GP (ha) [↓] % primary care clinic with contraceptive service (ha) [↓] % patients >75 years (ha) % primary care services with child health surveillance services (ha) Not reported
Gulliford 2002 (England) As above As above Deprivation scoree (ha) Per cent households headed by semi or unskilled manual occupation (ha) Per cent with limiting long-term illness (ha) Percent of households of ethnic minority (ha) Not reported
  1. Notes:
  2. a Increased prevalence or per cent unless otherwise stated.
  3. b Tested for inclusion in the final model with level of significance ≤ 0.05.
  4. c level of significance ≥ 0.05.
  5. d measured by health utility index mark 3 (HUI3).
  6. e based on proportion of people in a health authority who are unemployed, living in overcrowded accommodation, not in owner housing, and not owning a car (Townsend score).
  7. (i) individual level variable; (f) facility level variable; (d) district area level variable; (ha) health authority level variable; (c) proportion of community or residents in the area; ns – not significant; (ref) reference; [↑] associated with an increase in the hospital outcome; [↓] associated with a decreases in the hospital outcome GP – General practitioner, mmol/L – Millimoles per litre, COPD – Chronic obstructive pulmonary disease.