Socioeconomic Disparity in the Effect of SARS-CoV-2 on Outpatient Visits among People with Type 2 Diabetes in Taiwan

Kuan Hung Liu, Teng Lung Kuo, Nai Ying Ko, Yi Heng Li, Wen Chien Ko, Santi Martini, Chung Yi Li

Research output: Contribution to journalArticlepeer-review


The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak posed impact on healthcare. This study evaluated the effect of SARS-CoV-2 outbreak on the outpatient visits of patients with type 2 diabetes and determined the most affected groups. We analyzed Taiwan’s National Health Insurance data, including 1,922,702 patients diagnosed with type 2 diabetes from 2018 to 2021. Group-based trajectory modelling identified four distinct outpatient visit patterns, namely, consistently high (Group 1, 74.2%), low-to-high (Group 2, 8.1%), high-to-low (Group 3, 6.0%) and consistently low (Group 4, 11.7%) utilization. Logistic regression was used to analyze correlations between trajectory types and patients’ demographics and health statuses. Group 3 members had higher odds of being male [adjusted odds ratio (aOR) = 1.04, 95% confidence interval (CI) 1.03-1.05] and earning below 20,000 New Taiwan Dollar monthly (aOR = 1.29, 95% CI 1.26-1.31) than those in Group 1. However, they were less likely to be under 80 years old (aOR = 0.70-0.97), from lower median family income regions (aOR = 0.81-0.89) or possess a Charlson Comorbidity Index score > 2 (aOR = 0.67, 95% CI 0.66-0.68). Patients with lower income in affluent areas displayed the highest likelihood of falling into Group 3. Patients with type 2 diabetes and low income from wealthy areas were vulnerable during the pandemic. This result emphasizes the need to target resources and support for this subgroup during such crises.

Original languageEnglish
Pages (from-to)211-220
Number of pages10
JournalTohoku Journal of Experimental Medicine
Issue number3
Publication statusPublished - Mar 2024


  • SARS-CoV-2
  • claims analysis
  • latent class analysis
  • socioeconomic disadvantage
  • type 2 diabetes mellitus


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