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dc.contributor.authorKreft, D
dc.contributor.authorMcGuinness, MB
dc.contributor.authorDoblhammer, G
dc.contributor.authorFinger, RP
dc.date.accessioned2020-12-17T03:07:50Z
dc.date.available2020-12-17T03:07:50Z
dc.date.issued2018-04-05
dc.identifierpii: PONE-D-17-43087
dc.identifier.citationKreft, D., McGuinness, M. B., Doblhammer, G. & Finger, R. P. (2018). Diabetic retinopathy screening in incident diabetes mellitus type 2 in Germany between 2004 and 2013-A prospective cohort study based on health claims data. PLOS ONE, 13 (4), https://doi.org/10.1371/journal.pone.0195426.
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/11343/254756
dc.description.abstractOBJECTIVE: To assess factors associated with diabetic retinopathy (DR) screening uptake following a diagnosis of type 2 diabetes mellitus (type 2 diabetes) in Germany. MATERIALS AND METHODS: A nationally representative prospective sample of individual-level health claims data for 250,000 members from Germany's largest public insurance provider in 2004-2013 was assessed. In the sample, 26,560 persons with incident type 2 diabetes were identified. Factors associated with subsequent DR screening were assessed using descriptive statistics, Kaplan-Meier estimator, and Cox regression analysis. RESULTS: On average 27.6 visits to an ophthalmologist per 100 person-years in persons with incident type 2 diabetes occurred. Half of all incident cases (Kaplan-Meier estimator) had not seen an ophthalmologist after more than two years (2.25 years) following their diabetes diagnosis. In the multivariate analysis, an older age (from hazard ratio HR(70-74) = 0.93 [95%-CI: 0.89-0.97] to HR(90+) = 0.50 [95%-CI: 0.42-0.60] compared to persons aged 50-69 years) and a higher disability level (i.e. HR(disability level 3) = 0.30 [95%-CI: 0.25-0.36]) were associated with a lower likelihood, while female sex (HR = 1.12 [95%-CI: 1.08-1.15]), six or more comorbidities (HR = 1.26 [95%-CI: 1.15-1.37]), moderate (HR = 1.51 [95%-CI: 1.46-1.56]) or severe type 2 diabetes (HR = 1.53 [95%-CI: 1.45-1.61]) as well as being enrolled in a type 2 diabetes disease management program (HR = 1.78 [95%-CI: 1.69-1.87]) were associated with a higher likelihood of DR screening. CONCLUSIONS: A high proportion of newly diagnosed persons with type 2 diabetes did not follow current German recommendations for DR screening, impeding timely detection and management of potential complications. This was more apparent among persons who were men, older or had a disability. The uptake of screening was considerably greater among those enrolled in a diseases management program. These factors need to be considered when planning DR screening services and/or referrals.
dc.languageEnglish
dc.publisherPUBLIC LIBRARY SCIENCE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleDiabetic retinopathy screening in incident diabetes mellitus type 2 in Germany between 2004 and 2013-A prospective cohort study based on health claims data
dc.typeJournal Article
dc.identifier.doi10.1371/journal.pone.0195426
melbourne.affiliation.departmentMelbourne School of Population and Global Health
melbourne.source.titlePLoS One
melbourne.source.volume13
melbourne.source.issue4
dc.rights.licenseCC BY
melbourne.elementsid1323266
melbourne.contributor.authorMcGuinness, Myra
dc.identifier.eissn1932-6203
melbourne.accessrightsOpen Access


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