{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:37Z","timestamp":1782496537664,"version":"3.54.5"},"reference-count":30,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,31]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Socioeconomic inequalities significantly impact access to healthcare services for individuals with type 2 diabetes mellitus (T2DM). This study investigates these inequalities in Iran, focusing on factors such as asset, sex, urban\u2013rural residence, age, education, employment status, and marital status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>This study used data from the national \u2018Diabetes Care (DiaCare)\u2019 study, a population-based survey conducted from 2018 to 2020 in Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Socioeconomic status (SES) was assessed using Principal Component Analysis (PCA) based on assets. Socioeconomic inequalities in access to physicians, pharmacies and laboratories were measured using the Concentration Index (CI) and Erreygers Corrected Concentration Index (ECI). Decomposition analysis was performed using a probit regression model to assess the contributions of various factors to the observed inequalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 13 315 patients with T2DM, 5.8% lacked access to physicians, 6.8% to pharmacies and 8.7% to laboratories. The CI was positive and statistically significant for access to physicians (0.0614), pharmacies (0.0787) and laboratories (0.0875), indicating better access concentrated among higher SES individuals. Urban residents had the largest positive marginal effects on access to physicians (0.032), pharmacies (0.078) and laboratories (0.053), with percentage contributions of 13.21%, 23.23% and 17.39%, respectively. Higher asset quintiles showed substantial contributions to inequalities, with the highest quintile contributing 10.5% to physician access inequality, 9.68% to pharmacy access and 9.16% to laboratory access. Education level also positively impacted access, with high school education contributing 0.64% and college education 0.52% to access inequalities. Sex differences showed a negative marginal effect for women, indicating slightly lower access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Socioeconomic factors, particularly asset, residence and education, significantly impact access to healthcare services for patients with T2DM in Iran. Policies should focus on reducing barriers to healthcare access, especially for lower SES and rural populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-097167","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T15:41:22Z","timestamp":1770219682000},"page":"e097167","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Socioeconomic inequalities in healthcare access among patients with type 2 diabetes in Iran: a cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9121-9590","authenticated-orcid":false,"given":"Adeleh","family":"Nikkhah","sequence":"first","affiliation":[{"name":"Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3173-9065","authenticated-orcid":false,"given":"Ali","family":"Darvishi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1804-6034","authenticated-orcid":false,"given":"Amirhossein","family":"Aghakhani","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6334-5469","authenticated-orcid":false,"given":"Ensieh","family":"Nasli Esfahani","sequence":"additional","affiliation":[{"name":"Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4649-5953","authenticated-orcid":false,"given":"Narges","family":"Zargar Balajam","sequence":"additional","affiliation":[{"name":"Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9498-6397","authenticated-orcid":false,"given":"Ramin","family":"Heshmat","sequence":"additional","affiliation":[{"name":"Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3441-3578","authenticated-orcid":false,"given":"Gita","family":"Shafiee","sequence":"additional","affiliation":[{"name":"Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"2026062610403142000_16.2.e097167.1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-13-1"},{"key":"2026062610403142000_16.2.e097167.2","doi-asserted-by":"crossref","DOI":"10.4103\/ijpvm.ijpvm_374_22","article-title":"A Scoping Review of Possible Solutions for Decreasing Socioeconomic Inequalities in Type 2 Diabetes Mellitus","volume":"15","author":"Gharacheh","year":"2024","journal-title":"Int J Prev Med"},{"key":"2026062610403142000_16.2.e097167.3","doi-asserted-by":"crossref","DOI":"10.1016\/j.ssmph.2020.100596","article-title":"Socioeconomic inequalities in type 2 diabetes in employed individuals, nonworking spouses and pensioners","volume":"11","author":"Safieddine","year":"2020","journal-title":"SSM Popul Health"},{"key":"2026062610403142000_16.2.e097167.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0279228","article-title":"Socioeconomic disparities in diabetes prevalence and management among the adult population in Bangladesh","volume":"17","author":"Ahsan","year":"2022","journal-title":"PLoS One"},{"key":"2026062610403142000_16.2.e097167.5","doi-asserted-by":"crossref","first-page":"2971","DOI":"10.1038\/s41598-023-29978-y","article-title":"Socioeconomic inequality in awareness, treatment and control of diabetes among adults in India: Evidence from National Family Health Survey of India (NFHS), 2019\u20132021","volume":"13","author":"Maiti","year":"2023","journal-title":"Sci Rep"},{"key":"2026062610403142000_16.2.e097167.6","doi-asserted-by":"crossref","unstructured":"Torabipour A , Karimi S , Amini-Rarani M , et al . 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