{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T21:42:08Z","timestamp":1788298928820,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Socio\u2010economic status (SES) influences diabetes onset, progression and treatment. In this study, the associations between SES and use of hospital care were assessed, focusing on hospitalizations, technology and cardiovascular complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This was an observational cohort study comprising 196\u2009695 patients with diabetes (all types and ages) treated in 65 hospitals across the Netherlands from 2019 to 2020 using reimbursement data. Patients were stratified in low, middle, or high SES based on residential areas derived from four\u2010digit zip codes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Children and adults with low SES were hospitalized more often than patients with middle or high SES (children: 22%, 19% and 15%, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001, adults: 28%, 25% and 23%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Patients with low SES used the least technology: no technology in 48% of children with low SES versus 40% with middle SES and 38% with high SES. In children, continuous subcutaneous insulin infusion (CSII) and real\u2010time continuous glucose monitoring (rtCGM) use was higher in high SES {CSII: odds ratio (OR) 1.54 [95% confidence interval (CI) 1.35\u20101.76];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001; rtCGM OR 1.39 [95% CI 1.20\u20101.61];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001} and middle SES [CSII: OR 1.41 (95% CI 1.24\u20101.62);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001; rtCGM: OR 1.27 (95% CI 1.09\u20101.47);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.002] compared with low SES. Macrovascular (OR 0.78 (95% CI 0.75\u20100.80);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and microvascular complications [OR 0.95 (95% CI 0.93\u20100.98);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001] occurred less in high than in low SES.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Socio\u2010economic disparities were observed in patients with diabetes treated in Dutch hospitals, where basic health care is covered. Patients with low SES were hospitalized more often, used less technology, and adults with high SES showed fewer cardiovascular complications. These inequities warrant attention to guarantee equal outcomes for all.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15440","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T01:23:57Z","timestamp":1705454637000},"page":"1386-1394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Socio\u2010economic disparities in hospital care among\n                    <scp>Dutch<\/scp>\n                    patients with diabetes mellitus"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2415-1239","authenticated-orcid":false,"given":"Silvia A. G.","family":"de Vries","sequence":"first","affiliation":[{"name":"Department of Vascular Medicine Amsterdam University Medical Centers  Amsterdam The Netherlands"},{"name":"Scientific bureau, Dutch Institute for Clinical Auditing  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo C. J.","family":"Sas","sequence":"additional","affiliation":[{"name":"Diabeter, Center for Pediatric and Adult Diabetes Care and Research  Rotterdam The Netherlands"},{"name":"Department of Pediatrics, Division of Pediatric Endocrinology Erasmus University Medical Center, Sophia Children's Hospital  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5449-1015","authenticated-orcid":false,"given":"Jessica C. G.","family":"Bak","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine Amsterdam University Medical Centers  Amsterdam The Netherlands"},{"name":"Scientific bureau, Dutch Institute for Clinical Auditing  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8095-9155","authenticated-orcid":false,"given":"Dick","family":"Mul","sequence":"additional","affiliation":[{"name":"Diabeter, Center for Pediatric and Adult Diabetes Care and Research  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1926-7659","authenticated-orcid":false,"given":"Max","family":"Nieuwdorp","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine Amsterdam University Medical Centers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6173-0662","authenticated-orcid":false,"given":"Michel W. 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M.","family":"Wouters","sequence":"additional","affiliation":[{"name":"Scientific bureau, Dutch Institute for Clinical Auditing  Leiden The Netherlands"},{"name":"Department of Biomedical Data Sciences Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9406-9057","authenticated-orcid":false,"given":"Carianne L.","family":"Verheugt","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine Amsterdam University Medical Centers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(23)01301\u20106"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.063374"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.037454"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci20\u20100053"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22\u20101954"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwab065"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010022\u201005854\u20108"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20\u20100257"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0177210"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14906"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592\u2010016\u20100912\u20107"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/19322968221091299"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0340"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2022.110198"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271110"},{"key":"e_1_2_10_18_1","volume-title":"Diabetes Mellitus in Nederland: Prevalentie naar Migratieachtergrond en Sociaaleconomische Status","author":"Horsselenberg M","year":"2022"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939\u2010017\u20100553\u20107"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2022.09.018"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15105"},{"key":"e_1_2_10_22_1","unstructured":"The Netherlands Institute for Social Research. 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