Evidence map›Paper›PMID 37706640›Full record

ArticleScandinavian journal of primary health care2023

Use of primary health care services and mortality in older patients with type 2 diabetes with or without comorbidities.

E Mellanen, T Kauppila, H Kautiainen, M Lehto, O Rahkonen, K Pitkälä, M K Laine

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scandinavian journal of primary health care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 33% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Observational
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 1 institution in 2 countries.

E MellanenDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0003-4946-5768
T KauppilaDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-6155-0300
H KautiainenDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0003-0786-0858
M LehtoDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0001-7315-2118
O RahkonenDepartment of Public Health, University of Helsinki, Helsinki, Finland.ORCID 0000-0002-7202-3274
K PitkäläDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0001-9659-6985
M K LaineDepartment of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-1848-1514
University of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to examine primary health care (PHC) service utilization and mortality in older patients with type 2 diabetes (T2D) with or without comorbidities. DESIGN AND

settingA cohort study in PHC in the city of Vantaa, Finland. Follow-up period was set between the years 2011 and 2018. SUBJECTS: PHC patients aged 60 years or more with a T2D were included.

main outcome measuresService utilization was defined as the number of face-to-face appointments and telephone contacts between a patient and general practitioner (GP) or nurse. The presence of comorbidities was defined using the Charlson Comorbidity Index (CCI). Mortality was assessed using hazard ratio (HR) and standardized mortality ratio (SMR).

resultsIn total, 11,020 patients were included and followed for 71,596 person years. Mean age of the women and men in the beginning of follow-up were 71 and 69 years, respectively. The patients in the study cohort had a mean of eight appointments per person year to the GPs or nurses. Patients with T2D with comorbidities had more appointments than patients with T2D without comorbidities (incidence rate ratio (IRR) 1.44 [95% CI 1.39-1.49]). Increase in the number of all appointments reduced mortality in patients with T2D with and without comorbidities. Between patients with T2D with comorbidities and patients with T2D without comorbidities, the age and sex adjusted HR for death was 1.50 (95% CI 1.39-1.62). The SMR was higher in patients with T2D with comorbidities (1.83 [95% CI 1.74-1.92]) than in patients with T2D without comorbidities (0.91 [95% CI 0.86-0.96]).

conclusionsIn older patients with T2D, the presence of comorbidities was associated with increased use of PHC services and increased mortality. Increase in the number of appointments was associated with reduced mortality in patients with T2D with or without comorbidities.Key PointsIn older patients with T2D, it has not been studied whether and to what extend multimorbidity affects use of PHC services and mortality.The presence of comorbidities according to the Charlson Comorbidity Index (CCI) was associated with increased use of PHC services.The number of appointments to GPs or nurses was associated with reduced mortality in patients with T2D with or without comorbidities according to the CCI.

Indexed as

Diabetes Mellitus, Type 2AgedCohort StudiesComorbidityFemaleHealth ServicesHumansMalePrimary Health Careagedcomorbiditymortalityprimary healthcareservice utilizationType 2 diabetes mellitus

Identifiers

PMID37706640
PMCPMC11001330
OpenAlexW4386725787

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.