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Updated: Jun 19, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
[Determinants of avoidable hospitalization for type2 diabetes. Narrative review]
Elizabeth Hoyos-Loya1, María Cecilia González-Robledo2, Juan Pablo Gutiérrez3
1Escuela de Salud Pública de México, Santa María Ahuacatitlán, Cuernavaca, Morelos, México.
Objective:
To identify the structural and intermediate determinants associated with avoidable hospitalizations (AH) of patients with type2 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.
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