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Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea

AIMS/INTRODUCTION: Frequent emergency department (ED) visitors are medically vulnerable individuals. We identified the characteristics of “frequent ED users” among Korean patients with type 2 diabetes mellitus. MATERIALS AND METHODS: We used the Health Insurance Review and Assessment Service Nationa...

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Autores principales: Ustulin, Morena, Woo, Junghoon, Woo, Jeong‐taek, Rhee, Sang Youl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835454/
https://www.ncbi.nlm.nih.gov/pubmed/28686322
http://dx.doi.org/10.1111/jdi.12712
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author Ustulin, Morena
Woo, Junghoon
Woo, Jeong‐taek
Rhee, Sang Youl
author_facet Ustulin, Morena
Woo, Junghoon
Woo, Jeong‐taek
Rhee, Sang Youl
author_sort Ustulin, Morena
collection PubMed
description AIMS/INTRODUCTION: Frequent emergency department (ED) visitors are medically vulnerable individuals. We identified the characteristics of “frequent ED users” among Korean patients with type 2 diabetes mellitus. MATERIALS AND METHODS: We used the Health Insurance Review and Assessment Service National Patient Sample, which is a nationally representative sample. Patients (n = 109,412) with type 2 diabetes mellitus as a primary or secondary diagnosis at one of their visits were included. Individuals were classified into three groups according to the number of ED visits: frequent (≥4 visits), occasional (<4 visits) and non‐users of the ED. The characteristics of the patients that distinguished frequent users from the other groups were investigated. RESULTS: Frequent ED users were mainly men (P < 0.001), with longer treatment duration (P < 0.001), more frequent comorbidities (cardiovascular and chronic kidney disease) and primary diagnosis made by surgery (P = 0.0028). They had higher mortality (P = 0.0085), longer hospitalization duration (P < 0.001), higher costs per visit (P < 0.001) and more often required medical protection (P < 0.001). These patients were treated more frequently with sulfonylurea, insulin, meglitinide and alpha‐glucosidase inhibitors (P < 0.05). CONCLUSIONS: The present findings suggest that frequent users of the ED with type 2 diabetes mellitus have serious health conditions, a poor socioeconomic situation and tend to take some medicines (sulfonylurea, etc.), which often are associated with hypoglycemia. Attention should be given to therapy, and to patients with renal and cardiovascular diseases to decrease the dependency of these patients on the ED.
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spelling pubmed-58354542018-03-07 Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea Ustulin, Morena Woo, Junghoon Woo, Jeong‐taek Rhee, Sang Youl J Diabetes Investig Articles AIMS/INTRODUCTION: Frequent emergency department (ED) visitors are medically vulnerable individuals. We identified the characteristics of “frequent ED users” among Korean patients with type 2 diabetes mellitus. MATERIALS AND METHODS: We used the Health Insurance Review and Assessment Service National Patient Sample, which is a nationally representative sample. Patients (n = 109,412) with type 2 diabetes mellitus as a primary or secondary diagnosis at one of their visits were included. Individuals were classified into three groups according to the number of ED visits: frequent (≥4 visits), occasional (<4 visits) and non‐users of the ED. The characteristics of the patients that distinguished frequent users from the other groups were investigated. RESULTS: Frequent ED users were mainly men (P < 0.001), with longer treatment duration (P < 0.001), more frequent comorbidities (cardiovascular and chronic kidney disease) and primary diagnosis made by surgery (P = 0.0028). They had higher mortality (P = 0.0085), longer hospitalization duration (P < 0.001), higher costs per visit (P < 0.001) and more often required medical protection (P < 0.001). These patients were treated more frequently with sulfonylurea, insulin, meglitinide and alpha‐glucosidase inhibitors (P < 0.05). CONCLUSIONS: The present findings suggest that frequent users of the ED with type 2 diabetes mellitus have serious health conditions, a poor socioeconomic situation and tend to take some medicines (sulfonylurea, etc.), which often are associated with hypoglycemia. Attention should be given to therapy, and to patients with renal and cardiovascular diseases to decrease the dependency of these patients on the ED. John Wiley and Sons Inc. 2017-08-17 2018-03 /pmc/articles/PMC5835454/ /pubmed/28686322 http://dx.doi.org/10.1111/jdi.12712 Text en © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Articles
Ustulin, Morena
Woo, Junghoon
Woo, Jeong‐taek
Rhee, Sang Youl
Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea
title Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea
title_full Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea
title_fullStr Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea
title_full_unstemmed Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea
title_short Characteristics of frequent emergency department users with type 2 diabetes mellitus in Korea
title_sort characteristics of frequent emergency department users with type 2 diabetes mellitus in korea
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835454/
https://www.ncbi.nlm.nih.gov/pubmed/28686322
http://dx.doi.org/10.1111/jdi.12712
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