- Title
- Impact of diabetes on women’s health outcomes: survival, healthy life expectancy, and health related quality of life
- Creator
- Wubishet, Befikadu Legesse
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: Diabetes is one of the major chronic diseases posing a huge health and economic burden to patients, families, and health care systems in almost all corners of the world. Mainly due to its association with numerous complications and comorbidities, diabetes negatively affects patients’ health outcomes, such as health-related quality of life (HRQOL), survival, and healthy life expectancy (HLE). Therefore, quantifying the impacts of diabetes based on methods that enable accurate identification of patients has important policy and practice implications. Aims: The thesis aimed to: 1) demonstrate a robust method of diabetes case ascertainment through simultaneous use of multiple data sources; and 2) assess the impact of diabetes on survival, HLE, and HRQOL. Methods: The participants in this thesis were the 1921–26 and 1946–51 birth cohorts of the Australian Longitudinal Study on Women’s Health (ALSWH). ALSWH is a population-based prospective longitudinal study among Australian women that is largely focused on women’s health and its determinants. The data sources used in this thesis were the ALSWH survey data and linked administrative datasets, including the Pharmaceutical Benefits Scheme (PBS), the Medicare Benefits Schedule (MBS), Admitted Patients Data Collection (APDC), and the National Death Index datasets. Results: The findings revealed that Medicare Australia’s datasets (PBS and MBS) had a moderate to substantial level of agreement with both the survey and hospital admission data in identifying women with diabetes. This thesis revealed that diabetes is one of the chronic conditions for which the validity and completeness of case ascertainment can be improved through the simultaneous use of multiple data sources. Women with diabetes had shorter survival compared to women without diabetes, but even those women with prevalent diabetes had a median survival of nearly 10 years at ages 76–81 years. Diabetes was associated with reductions in total life expectancy (TLE), HLE, and the proportion of remaining life years spent in good health at all ages after 70 years. Low education, having three or more comorbidities, and obesity were also associated with reductions in TLE and HLE and increased unhealthy life expectancy. Women with diabetes had significant reductions in HRQOL scores over time compared to women without diabetes. Conclusions: The findings of this thesis indicated that the validity and completeness of diabetes case ascertainment can be improved through simultaneous use of multiple data sources. Diabetes had a larger negative impact on women’s HLE than their overall survival. Lower educational status, multimorbidity, and obesity were also negatively associated with women’s health outcomes. These findings suggest a need for interventions aimed at diabetes prevention; and further improvements in the care of women with diabetes to improve their quality of life and promote healthy ageing.
- Subject
- diabetes; women; healthy ageing; health related quality of life; health care administrative databases
- Identifier
- http://hdl.handle.net/1959.13/1469014
- Identifier
- uon:48141
- Rights
- Copyright 2021 Befikadu Legesse Wubishet
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 10 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 430 KB | Adobe Acrobat PDF | View Details Download |