Evidence map›Paper›PMID 40033328›Full record

ArticleBMC health services research2025

From inequalities to solutions: an explanatory sequential study on type 2 diabetes health services utilization.

Amin Torabipour, Saeed Karimi, Mostafa Amini-Rarani, Laleh Gharacheh

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. 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

4 authors.

Amin TorabipourSocial Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.ORCID http://orcid.org/0000-0002-8937-8004
Saeed KarimiHealth Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.ORCID http://orcid.org/0000-0003-4456-8733
Mostafa Amini-RaraniSocial Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. m.amini@mng.mui.ac.ir.ORCID http://orcid.org/0000-0002-4809-2237
Laleh GharachehSocial Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. lalehgharacheh@gmail.com.ORCID http://orcid.org/0000-0001-8711-8797

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealth inequities are a significant issue. This study aimed to measure and decompose socioeconomic inequality in the utilization of type 2 diabetes (T2D) services and propose solutions to mitigate these inequalities.

methodsThis explanatory sequential mixed-method study was conducted in two phases: quantitative and qualitative. A total of 2000 T2D patients from health centers, hospitals, and diabetes clinics in Isfahan and Khuzestan provinces, Iran, were selected. In the quantitative phase, the existence of inequality in the utilization of T2D services was examined using the Concentration Index (CI) approach. To determine the contribution of each explanatory variable to T2D inequality, we used concentration index decomposition analysis. In the qualitative phase, based on the main contributors identified in the quantitative phase, we conducted semi-structured interviews with purposefully selected key experts to identify solutions for reducing inequality in the utilization of T2D services.

resultsThe sample consisted of 65.3% men, with 40% of T2D patients being over 60 years old. The CI values were 0.31 (p < 0.05) for outpatient services, -0.10 (p > 0.05) for inpatient services, and 0.11 (p < 0.05) for pharmaceutical services. This indicates an inequality in the utilization of outpatient and pharmaceutical services among T2D patients, while the inequality in inpatient services was not significant. The main variables contributing to inequality in outpatient services were health status (33.54%), basic insurance (27.43%), and socioeconomic status (24.08%). For pharmaceutical services, the contributing variables were health status (22.20%), basic insurance (13.63%), and socioeconomic status (34.35%). Experts' solutions to reduce socioeconomic inequalities in Iran were classified into three main themes: socioeconomic status, health status, and basic insurance, with 29 sub-themes.

conclusionThe results suggest that targeted health interventions for poor T2D patients are recommended. Efforts towards universal coverage in outpatient care and commonly used pharmaceutical items, such as: Antidiabetic Drugs, Triglyceride Control Drugs, Cardiovascular Drugs, Neuropathy Drugs, and Nephropathy Drugs, should be considered.

Indexed as

Diabetes Mellitus, Type 2Healthcare DisparitiesPatient Acceptance of Health CareAdultAgedFemaleHumansInterviews as TopicIranMaleMiddle AgedQualitative ResearchSocioeconomic FactorsConcentration indexDecomposition qualitative approachDiabetes mellitusInequalitySocioeconomic statusUtilization

Identifiers

PMID40033328
PMCPMC11874842

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.