Trends and disparities in diabetes care following China's healthcare reform: Evidence from the 2011–12 and 2015–16 China Health and Retirement Longitudinal Study

To address the high burden of diabetes, China has managed to strengthen diabetes care during the past decade. This study aimed to examine trends and disparities in the coverage of diabetes care among diabetes patients aged 45 years and older following China's healthcare reform. We used data from the 2011-12 baseline survey and 2015-16 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). The prevalence of three diabetes care indicators were compared between the two periods and by participants' characteristics. Logistic regressions and random-effect logit model were used to investigate the socioeconomic and geographic disparities in diabetes care indicators and assess whether there was a significant improvement in these disparities from 2011-12 to 2015-16. We found the prevalence of diabetes among adults aged 45 years and above increased from 16.37% in 2011-12 to 20.33% in 2015-16 in China. Between the 2011-12 and 2015-16 surveys, the proportions of diabetes patients who received health education increased from 31.68% to 35.63%, diabetes-related examination from 32.21% to 41.32%, and diabetes treatment from 30.8% to 36.6%. Disparities in the coverage of diabetes care still existed; while geographic disparities improved significantly during the study period, individual socioeconomic disparities persisted. To address disparities in diabetes care, more effort needs to be directed to improve the primary care system to ensure the quality and timely delivery of diabetes care. Tailored programs should be carried out with more attention given to underserved groups with less educational attainment and lower economic status.