Determinants of avoidable hospitalization for type 2 diabetes. Narrative review

Objective: To identify the structural and intermediate determinants associated with avoidable hospitalizations (AH) of patients with type 2 diabetes mellitus (T2DM). Design: Literature review based on narrative synthesis. Data sources: Databases: PubMed, Science Direct, and Latin American and Caribbean Literature in Health Sciences (LILACS). Study selection: Documents were selected and analyzed under a critical literature review, considering inclusion and exclusion criteria. Data extraction: Information extracted from each selected article was synthesized based on the countries' income levels and the social determinants of health framework. Results: A total of 4,166 articles were relevant, 36 were selected for review. From this selection, 21 were publications conducted in high-income countries, 14 in upper-middle-income countries, and one in lower-middle-income countries. The review identified that the coverage of health services--mainly primary health care-- and health insurance contribute to reducing the risk of AH for T2DM, while social inequalities tend to increase the risk. Conclusions: The AH due to T2DM are susceptible to reduction through policies that contribute to increasing effective access to health services (availability, insurance), since they express social inequality, occurring to a greater extent in socioeconomically vulnerable populations. This review also provides evidence of the need to expand research on this topic in middle and low-income countries. (c) 2024 Published by Elsevier Espana, a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).