• Samantha Gardiner, Shalley Robins, and Daniel Terry.
• Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia.
• Aust J Rural Health. 2019 Feb 1; 27 (1): 49-56.

ObjectiveTo identify the extent to which rurality influences the admission and mortality rates for acute circulatory complications among people with type 2 diabetes mellitus.DesignRetrospective study.SettingAll Victorian hospitals.ParticipantsState-wide hospital admissions from 1 July 2010 to 30 June 2015 using the Victorian Admitted Episodes Dataset. Data included patients with type 2 diabetes mellitus and diagnosis of acute cardiovascular events, acute cerebrovascular haemorrhage or infarction, acute peripheral vascular events or hypertensive diseases.Main Outcome MeasureRates of admission and mortality were calculated for local government areas and Department of Health regions. Regression analysis identified the influence between admission rates and various predictor variables.ResultsIn total, 5785 emergency hospital admissions occurred during the study period, with the highest and lowest mortality and admission rates occurring in rural areas. Moderately high admission rates were identified in urban areas. Cardiovascular events far outnumbered other acute circulatory admissions. Regression analysis identified a number of significant socioeconomic variables, primarily for metropolitan residents. Socioeconomic disadvantage was the only significant factor in rural areas.ConclusionVictorian admission and mortality rates for acute circulatory complications are greatest in rural areas; yet, there is considerable heterogeneity in the admission rates within both rural and metropolitan areas. Furthermore, socioeconomic status is more influential than remoteness in determining emergency admissions. Further research needs to investigate the particular variables that lead to poorer outcomes rurally, investigate socioeconomic disadvantage in rural areas and have greater emphasis on peripheral vascular disease prevention.© 2019 National Rural Health Alliance Ltd.

31 keywords...

hide…