Evidence map›Paper›PMID 35862512›Full record

ArticlePreventing chronic disease2022

Urban-Rural Differences in Health Care Utilization and COVID-19 Outcomes in Patients With Type 2 Diabetes.

Annemarie G Hirsch, Cara M Nordberg, Karen Bandeen-Roche, Jonathan Pollak, Melissa N Poulsen, Katherine A Moon, Brian S Schwartz

Open access · diamondAbstract read
In one paragraph

Article in Preventing chronic disease, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 34% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Annemarie G HirschDepartment of Population Health Sciences, Geisinger, 100 N Academy Ave, Danville, PA 17822. Email: aghirsch@geisinger.edu.
Cara M NordbergDepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania.
Karen Bandeen-RocheDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Jonathan PollakDepartment of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Melissa N PoulsenDepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania.
Katherine A MoonDepartment of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Brian S SchwartzDepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania.
Geisinger Health System · USJohns Hopkins University · US

Funding

Component A: A multi-level study of community context and type 2 diabetes and coronary heart disease using electronic health record and new primary data across nested geographies in PennsylvaniaU01DP006296 · DP · GEISINGER CLINIC · PI HIRSCH, ANNEMARIE GREGORY · 2017 to 2021
$3.8M
ACL HHS U01DP006296NCCDPHP CDC HHS U01 DP006296
6 · The paper itself

Abstract

introductionTwo studies in Pennsylvania aimed to determine whether community type and community socioeconomic deprivation (CSD) 1) modified associations between type 2 diabetes (hereinafter, diabetes) and COVID-19 hospitalization outcomes, and 2) influenced health care utilization among individuals with diabetes during the COVID-19 pandemic.

methodsThe hospitalization study evaluated a retrospective cohort of patients hospitalized with COVID-19 through 2020 for COVID-19 outcomes: death, intensive care unit (ICU) admission, mechanical ventilation, elevated D-dimer, and elevated troponin level. We used adjusted logistic regression models, adding interaction terms to evaluate effect modification by community type (township, borough, or city census tract) and CSD. The utilization study included patients with diabetes and a clinical encounter between 2017 and 2020. Autoregressive integrated moving average time-series models evaluated changes in weekly rates of emergency department and outpatient visits, hemoglobin A

resultsIn the hospitalization study, of 2,751 patients hospitalized for COVID-19, 1,020 had diabetes, which was associated with ICU admission and elevated troponin. Associations did not differ by community type or CSD. In the utilization study, among 93,401 patients with diabetes, utilization measures decreased in March 2020. Utilization increased in July, and then began to stabilize or decline through the end of 2020. Changes in HbA

conclusionDiabetes was associated with selected outcomes among individuals hospitalized for COVID-19, but these did not differ by community features. Utilization trajectories among individuals with diabetes during the pandemic were influenced by community type and CSD and could be used to identify individuals at risk of gaps in diabetes care.

Indexed as

COVID-19Diabetes Mellitus, Type 2HospitalizationHumansPandemicsPatient Acceptance of Health CareRetrospective StudiesRisk FactorsSARS-CoV-2TroponinTroponin

Identifiers

PMID35862512
PMCPMC9336194
OpenAlexW4285726009

What OpenQuestion holds

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LicenceCC BY
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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.