Are Diabetic Physicians at a Lower Risk of Hospitalization for Coronary Heart Disease? A Nationwide Cohort Study in Taiwan

Abstract

It is not uncommon for physicians to work through illness and to be reluctant to seek health care from their colleagues, which is detrimental for quality of care. This study sought to assess the risk of admission for coronary artery diseases (CADs) in diabetic physicians. A cohort of 995 diabetic physicians and 9950 age- and sex-matched controls with diabetes were identified in 2000 and were followed to the end of 2008. Over an 8-year period, 200 (20.1%) diabetic physicians and 2255 (22.7%) controls were admitted for CAD. After controlling for potential confounders, diabetic physicians experienced a reduced, but insignificantly, adjusted odds ratio (OR) of CAD admission (OR = 0.89; 95% confidence interval = 0.75-1.06). Diabetic physicians in Taiwan were not at a significantly reduced risk of CAD admission. Future studies are needed to further explore the barriers that impede diabetic physicians from appropriately managing their disease.

Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

“…The National Health Insurance of Taiwan is compulsory and covers all citizens except prison inmates. Study subjects were obtained from the National Health Insurance Research Database (NHIRD) [ 15 ] and released for research purposes by the National Health Research Institute, Taipei, Taiwan. The NHIRD covers nearly all (99%) inpatient and outpatient claims for Taiwan’s total population of >22 million; furthermore, NHIRD is one of the largest and most comprehensive databases in the world.…”

“…The NHIRD covers nearly all (99%) inpatient and outpatient claims for Taiwan’s total population of >22 million; furthermore, NHIRD is one of the largest and most comprehensive databases in the world. This database has been used extensively in various studies, including hip fracture [ 18 , 19 , 20 , 21 , 22 , 23 ] and physicians’ health [ 15 , 24 , 25 , 26 ]. The NHIRD provides encrypted patient identification number, gender, birthday, dates of admission and discharge, medical institutions providing health services, International Classification of Diseases , Ninth Revision , Clinical Modification (ICD-9-CM) diagnosis (up to five) and procedure (up to five) codes, outcome at hospital discharge (recovered, died, or transferred), and fees charged to patients.…”

“…This difference is possible because the trochanteric hip site is composed of more cancellous bone with a higher bone turnover than the cervical hip site; thus, the former is more likely affected by lifestyle habits, such as physical activities, than the latter [ 7 , 8 , 9 , 10 , 11 , 12 ]. However, these hypotheses should be further verified because physicians may not always be able to take the advantage of being a medical professional [ 13 , 14 , 15 ]. For instance, physicians with diabetes are not at a lower risk of hospitalization for coronary heart disease than those without diabetes [ 15 ], suggesting that some barriers may exist and impede physicians’ intention to utilize preventive measures or to manage their health effectively.…”

“…However, these hypotheses should be further verified because physicians may not always be able to take the advantage of being a medical professional [ 13 , 14 , 15 ]. For instance, physicians with diabetes are not at a lower risk of hospitalization for coronary heart disease than those without diabetes [ 15 ], suggesting that some barriers may exist and impede physicians’ intention to utilize preventive measures or to manage their health effectively. Moreover, physicians experience a high prevalence of job stress and burnout [ 13 ], which may theoretically lead to osteopenia and osteoporosis [ 14 , 16 ].…”