Evidence map›Paper›PMID 30464660›Full record

ArticleRisk management and healthcare policy2018

Associations between structures and resources of primary care at the district level and health outcomes: a case study of diabetes mellitus care in Thailand.

Daoroong Komwong, Jiruth Sriratanaban

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in Risk management and healthcare policy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.3field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Daoroong KomwongDepartment of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, sjiruth@gmail.com.
Jiruth SriratanabanDepartment of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, sjiruth@gmail.com.
Chulalongkorn University · TH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe structural factors of primary care potentially influence its performance and quality. This study investigated the association between structural factors, including available primary care resources and health outcomes, by using diabetes-related ambulatory care sensitive conditions hospitalizations under the Universal Coverage Scheme in Thailand.

methodsA 2-year panel study used secondary data compiled at the district level. Administrative claim data from 838 districts during the 2014-2015 fiscal years from the National Health Security Office were used to analyze overall diabetes mellitus (DM) hospitalizations and its three subgroups: hospitalizations for uncontrolled diabetes, short-term complications, and long-term complications. Primary care structural data were obtained from the Ministry of Public Health. Generalized estimating equations were used to estimate the influence of structural factors on the age-standardized DM hospitalization ratio.

resultsA higher overall DM and uncontrolled diabetes hospitalization ratio was related to an increasing concentration of outpatient utilization (using the Herfindahl-Hirschman Index) (overall DM; beta [standard error, SE]=0.003 [0.001], 95% CI 0.000, 0.006) and decreasing physician density and bed supply (overall DM; beta [SE]=-1.350 [0.674], 95% CI -2.671, -0.028), beta [SE]=-0.023 [0.011], 95% CI -0.045, -0.001, respectively). Hospitalizations for short-term complications increased with a decrease in health care facility density, whereas hospitalizations for long-term complications increased as that density increased. Rurality was strongly associated with higher hospitalization ratios for all DM hospitalizations except short-term complications.

conclusionsThis study identified structural factors associated with health outcomes, many of which can be changed through reorganization at the district level.

Indexed as

ambulatory care sensitive conditionsdiabetes mellitushealth human resourcesprimary carestructural characteristics

Identifiers

PMID30464660
PMCPMC6208489
OpenAlexW2898481232

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.