Do physicians with diabetes have differences in dialysis use and survival than other patients with diabetes

Shang Jyh Chiou, Pei Tseng Kung, James M Naessens, Kuang Hua Huang, Yu Chia Chang, Yueh Hsin Wang, Wen Chen Tsai

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Aims: To assess whether the increased knowledge and resources available to physicians led to differences in dialysis and survival rates between physicians and non-physician patients with diabetes. Methods: All newly diagnosed (1997-2009) type 2 diabetes patients aged ≥35 years from the National Health Insurance Program of Taiwan database were included. After propensity score matching (1:10), we estimated the relative risk of dialysis and death using Cox proportional hazards model adjusted for demographic characteristics and comorbidities. Results: Physicians with diabetes were more likely to start dialysis than general patients, with a 48% increased hazard risk (HR) (P= 0.006). Physicians with diabetes had significantly lower risk of death (HR: 0.88; P= 0.025). However, those requiring dialysis had a non-significant increased risk of death (HR: 1.19). There was an increased HR for death in older physicians (HR: 1.81; P < 0.001) and those with cancer or catastrophic illness. The HR of dialysis (7.89; P < 0.0001) increased dramatically with increasing Charlson Comorbidity Index scores. Conclusions: Physicians with DM survived longer than other patients with diabetes, likely benefiting from their professional resources in disease control and prevention. Nonetheless, they displayed no advantage from their medical backgrounds compared with the general patients if they developed end stage renal disease.

Original languageEnglish (US)
Pages (from-to)382-390
Number of pages9
JournalDiabetes Research and Clinical Practice
Volume105
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Dialysis
Physicians
Survival
National Health Programs
Comorbidity
Catastrophic Illness
Propensity Score
Taiwan
Proportional Hazards Models
Type 2 Diabetes Mellitus
Chronic Kidney Failure
Survival Rate
Demography
Databases
Neoplasms

Keywords

  • Diabetes
  • Dialysis
  • Physician with diabetes
  • Survival analysis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Endocrinology
  • Medicine(all)

Cite this

Do physicians with diabetes have differences in dialysis use and survival than other patients with diabetes. / Chiou, Shang Jyh; Kung, Pei Tseng; Naessens, James M; Huang, Kuang Hua; Chang, Yu Chia; Wang, Yueh Hsin; Tsai, Wen Chen.

In: Diabetes Research and Clinical Practice, Vol. 105, No. 3, 2014, p. 382-390.

Research output: Contribution to journalArticle

Chiou, Shang Jyh ; Kung, Pei Tseng ; Naessens, James M ; Huang, Kuang Hua ; Chang, Yu Chia ; Wang, Yueh Hsin ; Tsai, Wen Chen. / Do physicians with diabetes have differences in dialysis use and survival than other patients with diabetes. In: Diabetes Research and Clinical Practice. 2014 ; Vol. 105, No. 3. pp. 382-390.
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