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Socioeconomic factors influencing participation in and drop-out from disease management programs for Diabetes Mellitus and Cardiovascular Risk Management in Almelo

Severijn, T.E. (2017) Socioeconomic factors influencing participation in and drop-out from disease management programs for Diabetes Mellitus and Cardiovascular Risk Management in Almelo.

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Abstract:Much research is carried out to determine the relation between socioeconomic status (SES) and health and access to healthcare. Common conclusion of the previous researches done is that lower SES individuals have worse health status, experience worse health and experience reduced access to healthcare. The incidence and prevalence of chronic diseases are higher among lower SES individuals than among higher SES individuals. Since lower SES individuals will have lower health literacy and worse lifestyle, it is important for these individuals to be supervised by their GP in order to manage their disease(s) well. This research will focus on the disease management programs for diabetes mellitus (DM) and cardiovascular risk management (CVRM), since these diseases are more common among lower SES individuals and lifestyle factors play an important role in the development of the diseases. It is not known whether lower SES individuals experience a reduced access in the disease management programs for DM and CVRM and if the higher SES and lower SES patients included in the program differ on patient characteristics as age, age at onset and BMI. Both the enrolment and drop-out of the disease management programs for DM and CVRM and the characteristics of the patients included in this programs will be determined in this study. This knowledge may help better guide the delivery of interventions in the disease management programs for DM and CVRM. In turn, this can lead to a lower burden of these diseases with better self-management. All of this is determined in the light of Almelo, a city which has some postal codes with a very low SES and some postal codes with a high SES. Data is extracted from the database of FEA, a federation for cooperative GPs in Almelo and is analysed with descriptive statistics in SPSS. Mann-Whitney U test is carried out to determine if there is a relation between SES and drop-out of the disease management programs, age, age at onset and BMI. It is shown that there is no significant relation between SES and drop-out of the disease management programs. The rate of enrolment was higher among the lower SES individuals in the DM disease management program, in the CVRM disease management the rate of enrolment was higher among the higher SES individuals, although not significantly. On patient characteristics it appears that lower SES individuals included in the DM program have a significantly higher BMI than higher SES individuals included. In the CVRM program it appeared that lower SES individuals participating because of CVD were significantly younger when included in the program than higher SES individuals. For patients included because they have an increased vascular risk a significant relation between SES and age, age at onset and BMI was found. All in all, these findings correspond with the large body of knowledge that is present. It is recommended for practice to better guide the interventions set up for lower SES individuals and also use other channels to reach these individuals than the GP. For further research it is recommended to further explore on which levels discrepancies between lower and higher SES individuals exists and how this affects the access to healthcare. Keywords: socioeconomic status (SES), diabetes mellitus (DM), cardiovascular diseases (CVD), enrolment, participation, drop-out, disease management program (DMP)
Item Type:Essay (Master)
Clients:
Universiteit Twente, Nederland
Faculty:TNW: Science and Technology
Subject:70 social sciences in general
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/73739
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