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HOSPITAL REGION, ETHNICITY, AND SOCIOECONOMIC STATUS ALL IMPACT PUBLICLY FUNDED INSULIN PUMP UPTAKE IN NEW ZEALAND PATIENTS WITH TYPE 1 DIABETES

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Abstract

Aims Insulin pump therapy (CSII) is becoming increasingly common for those living with Type 1 Diabetes (T1D), and has been publically funded in New Zealand since 2012. The aim of the current study was to examine national uptake of publicly funded pumps from 2012 to 2016, with a focus on the proportion of patients using pumps analysed according to District Health Board (DHB) as well as demographic characteristics. Methods Data from nationally held data collections including the New Zealand Virtual Diabetes Register were used to calculate the overall and subgroup proportions using pumps. Logistic regression analysis was then used to estimate the independent contributions of DHB of residence and sociodemographic characteristics to variations in pump use. Results Between 2012 and 2016, CSII for those living with T1D (n=17338) increased from 1.6 to 11.3 % overall. However, speed of uptake differed by DHB of residence, ethnicity, degree of deprivation, age, and gender. A 4-fold difference in uptake between highest and lowest using DHBs was seen after adjusting for known confounders. Conclusions From 2012 to 2016 there has been a steadily increasing uptake of CSII. Despite publicly funded access, disparities in use appear to exist, including by DHB of residence as well as traditionally described socio-demographic barriers to healthcare. Efforts to understand and reduce these disparities are required.

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