A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland

A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland Tom Pierse, Luke Barry, Liam Glynn, Andrew W Murphy, Sharon Cruise, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-16311/v2 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 24 Sep, 2020 Read the published version in BMC Public Health → Version 2 posted 11 You are reading this latest preprint version Show more versions Abstract Background: There are social and economic differences between Northern Ireland (NI) and the Republic of Ireland (ROI). There are also differences in the health care systems in the two jurisdictions. The aims of this study are to compare health (prevalence of diabetes and related complications) and health care utilisation (general practitioner, outpatient or accident and emergency utilisation) among older people with diabetes in the NI and ROI. Methods: Large scale comparable surveys of people over 50 years of age in Northern Ireland (NICOLA, wave 1) and the Republic of Ireland (TILDA, wave 1) are used to compare people with diabetes (type I and type II) in the two jurisdictions. The combined data set comprises 1,536 people with diabetes. A coarsened exact matching approach is used to compare health care utilisation among people with diabetes in NI and ROI with equivalent demographic, lifestyle and illness characteristics (age, gender, education, smoking status and self-related health, number of other chronic diseases and number of diabetic complications). Results: The overall prevalence of diabetes in the 50 to 84 years old age group is 3.4 percentage points higher in NI (11.1% in NI, 7.7% ROI, p-value < 0.01). The diabetic population in NI appear sicker – with more diabetic complications and more chronic illnesses. Comparing people with diabetes in the two jurisdictions with similar levels of illness we find that there are no statistically significant differences in GP, outpatient or A&E utilisation. Conclusion: Despite the proximity of NI and ROI there are substantial differences in the prevalence of diabetes and its related complications. Despite differences in the health services in the two jurisdictions the differences in health care utilisation for an equivalent cohort are small. Health Policy Infectious Diseases Health Economics & Outcomes Research Diabetes Complications Health Care Utilisation Quality and Outcomes Framework Figures Figure 1 Background Diabetic care is a substantial driver of overall health care utilisation and costs. In Europe and North America, the proportion of health care expenditure on diabetes in 2010 ranges from 6 to 14 per cent ( 1 ). In the Republic of Ireland, the incremental cost of additional health service use is estimated to be €89 million annually ( 2 ). Health care utilisation and health care costs among those with diabetes are strongly related to diabetic complications; in the UK, 80 per cent of diabetic health care costs are due to complications ( 3 , 4 ). In addition to direct health care costs, diabetes significantly impacts on mortality rates, quality of life and labour market productivity ( 5 , 6 ). It is currently difficult to make direct comparisons between the prevalence of diabetes in Northern Ireland (NI) and Republic of Ireland (ROI). In Northern Ireland (NI), based on register data, 5.6% of the population aged 18 and over have diabetes ( 7 ). While in ROI a similar register does not exist, it has been estimated that 5.2 per cent of those aged 18 and over have diabetes ( 8 ). However, given the strong relationship between diabetes prevalence, age and gender comparing these two figures is problematic. A previous study, based on prescribing databases in the two jurisdictions found clinically equivalent prevalence rates of diabetes in NI and ROI across all age groups ( 9 ). NI and ROI have operate different health care systems. In both, the GP is the primary point of contact between the health service and people with diabetes. However, there are differences in the way that GP services are delivered in NI and ROI. In NI practices provide publicly funded care, free at the point of use, to a defined list of patients on a universal basis. The Quality Outcomes Framework (QOF) system, in place from 2004, provides financial incentives for GPs to maintain disease registers and meet quality indicators. The QOF system resulted in three simultaneous changes: better data collection by GPs, public information on the quality of care, and pay for performance ( 10 ). For diabetes, GPs receive additional payment for having higher proportions of patients with biomarkers such as blood pressure, lipids and blood sugar in specified ranges as well as records of screening/examinations ( 11 ). However, beyond the upper thresholds of each QOF indicator, GPs receive no additional financial reward to improve care ( 12 ). In the UK QOF has been shown to be associated with improvements in both process and outcomes of diabetes care ( 13 ). In ROI, GPs have a mix of publicly funded and private fee paying patients. The mixed nature of GP care in ROI means that GPs who see additional private patients can generate more revenue ( 14 ). In contrast in NI, private patients as a potential revenue stream do not exist. In ROI, at the time the data for this study were collected (2011), there was no specific financial support for GPs providing primary care to patients with diabetes. While several diabetes initiatives were in place in Ireland, diabetic care was frequently unstructured and record keeping by many GPs was poor ( 15 , 16 ). However, structured reviews and record keeping are only one component of quality primary care. Access and quality of interaction in GP consultations, continuity of care, and access to practice nurses are important components of care quality ( 17-19 ). The supply of GPs has been shown internationally to be associated with improved outcomes, such as reduced mortality ( 20 ). In this context it is notable that there are fewer GPs in NI per capita than in ROI; the average GP list size was 1,620 in NI in 2014 ( 21 ) and 1,175 in ROI (1,335 based on Whole Time Equivalent, WTE), based on total number (head count) of GPs for 2014 and population numbers ( 22 ). While we do not have WTE values for GPs in NI, even if all GPs were working on a full time basis in NI, there would still be more supply in ROI. Differences in the supply of GPs may result in shorter consultation durations ( 23 , 24 ) and longer waiting times for non-emergency consultations in NI, as in the rest of the UK ( 25 , 26 ). Practice nurses play an increasingly important role in the provision of primary care ( 27 ). As with GPs there are more practice nurses per capita in ROI. In ROI there are 0.26 practice nurses per 1,000, this compares with an average of 0.2 in NI ( 22 , 28 , 29 ). Cost has been shown to be an important factor in the demand for GP care ( 30 ). While GP care is free at the point of use for patients in Northern Ireland, a substantial minority (31.5%) of people in ROI with diabetes are not covered by the medical card or GP visit card schemes and will have to pay for their GP care ( 31 ). For those who have to pay out of pocket for a GP consultation, the cost of a consultation is in the region of €50, which may represent a significant deterrent to attending ( 32 , 33 ). While the cost of attending the GP may be a deterrent for some people it may, by reducing demand, reduce capacity constraints that permit easier access for others ( 14 ). The approach to outpatient diabetes care varies widely across public hospitals in ROI in terms of the discharging of uncomplicated cases back to primary care ( 34 ). There is also substantial variation in waiting lists across hospitals for outpatient care. All patients have access to free public outpatient diabetes care but non-medical card holders (those who have to pay to access GP care) usually have to pay for diabetes services provided by their GP ( 34 ). This can result in a reluctance by some patients to be discharged to their GP ( 34 ). There is no costs to patients for attending outpatient clinics in NI. Outpatient waiting lists are not available for diabetes care. In this study, we examine, for patients aged 50 and over with diabetes, differences between NI and ROI in the prevalence of diabetes and the number and type of health care contacts (GP, Outpatient, A&E Visits and Hospital Nights). Older people are the main population of interest for examining health care utilisation by people with diabetes given this is where the disease is most prevalent – in the UK, 83 per cent of people with diabetes (type I and type II) are over the age of 50 ( 35 , 36 ). One previous study, using different data sources, has previously compared the age adjusted prevalence of diabetes between the two jurisdictions. Differences in entitlement to care (including sub-groups differentiated by income level) and utilization of care between the two parts of Ireland have been explored previously for the overall population ( 33 , 37 , 38 ). As far at the authors are aware a needs adjusted comparison of health care utilisation by people with diabetes is not available. Methods Data The Irish Longitudinal Study on Aging (TILDA) and Northern Irish Cohort for the Longitudinal Study of Aging (NICOLA) surveys, used in this study, are based on interviews and health assessments with a representative of the population aged 50 and over in both ROI and NI (see ( 39 ) and ( 40 ) for further details of the TILDA and NICOLA studies, including design, methodology, and assessments carried out). The health assessment comprised of a physical examination and a blood test carried out by a nurse at a health centre. The TILDA and NICOLA surveys are ideally designed for comparison with each other due to the similarity in the two surveys. Each survey consists of computer-assisted personal interviewing (CAPI) surveys containing identical questions on diabetes diagnosis and complications. Self-reported doctor diagnosed diabetes, directly comparable across the two surveys, is used in this study. The prevalence of diabetes is compared for age groups between 50 and 84 as there are no observations with diabetes over the age of 84 in the TILDA data. Self-reported health care utilisation variables examined in this study were GP utilisation, outpatient, A&E and hospital nights. Utilisation rates are all based on the previous 12 months. Survey work for TILDA was carried out in 2011 (Wave 1), survey work for NICOLA was carried out in 2014-2016 (Wave 1). Using the first wave of each survey is advantageous as attrition in later waves may not be at random. Estimates of the number of cases of diabetes in NI are based on NICOLA age and gender adusted prevalence rates and population estimates for 2014 ( 41 ). Statistical Approach Matching is a method for rebalancing observational data ( 42 ). A key advantage of matching over regression analysis is a reduced dependence on assumptions about functional form ( 43 ). A Coarsened Exact Matching (CEM) approach is used here to match observations in the two jurisdictions and allow for a direct comparison of outcomes. CEM is a type of matching process that involves the temporary coarsening of continuous variables followed by a direct matching between two groups. The CEM method involves categorising continuous variables into user defined groups. A stratum is created for each unique observation in the data set. Observations are dropped that do not have at least one observation from the two groups in the stratum. Thus, the CEM process involves pruning from both groups ( 44 ). This method was chosen over the Mahalanobis distance method of matching as we wish to match on a combination of continuous and dichotomous variables ( 45 ). Matching Variables Matching is done based on the presence and severity of health needs. Health needs are captured in age, sex, education, current smoking status, self-reported health, the number of chronic illnesses and the number of diabetic complications reported. Diabetic complications are defined here as heart attack, stroke, leg ulcers, kidney disease, neuropathy, retinopathy and nephropathy. These matching variables were selected based on previous findings from TILDA of the covariates of health care utilisation ( 46 ). A count of the number of diabetic complications is included as this has been shown to correlate with hospital utilisation ( 47 ). Similarly, chronic illnesses identified in the surveys were included in the matching as a count as there is little indication that more complex multi-morbidity indexes outperform a simple count ( 48 ). The available chronic illness in the surveys are: chronic lung disease; asthma; arthritis; osteoporosis; cancer; any emotional, nervous or psychiatric problems; alcohol or substance abuse; stomach ulcers; varicose ulcers; high blood pressure or hypertension and angina. Body Mass Index (BMI), glycosylated haemoglobin (HbA1c) and other biometric markers are not included in the analysis of health care utilisation as they are only available for the subsample that attended the health assessment. Number of Observations In total 17,008 people were surveyed (TILDA: 8,504 and NICOLA: 8,504). Both studies contain a small number of observations under 50 years included in the matching process (TILDA: 329 and NICOLA: 195). There were 16,681 observations (TILDA: 8,468 and NICOLA: 8,212) with no missing data in the matching and outcome variables. The combined data set comprises complete surveys from 1,536 people with diabetes (TILDA: 634 and NICOLA: 902). After the matching process there are a total of 906 observations (TILDA: 420 and NICOLA: 486). Results 3.1 Prevalence of Diabetes Figure 1 shows the percentage of individuals who report having received a diagnosis of diabetes from their doctor by sex and age group in NI and ROI. The prevalence rates for NI are higher across all age groups and genders. The overall prevalence in the 50 to 84 years old age group is 3.4 percentage points higher in NI (11.1% in NI, 7.7% ROI, p-value < 0.01). There are no observations in ROI for those in the over 85 years age group. [INSERT FIGURE 1 HERE] There is no indication from the data available that the higher prevalence rates in NI are due to higher case ascertainment. Among those for whom HbA1c data were available, the rates of undiagnosed diabetes (HbA1c > 48 mmol/mol (6.5 %) and no report of a diabetes diagnosis) are also higher in NI(0.8% in ROI vs 4.4% in NI). 3.2 Health of People with Diabetes Table 1 shows the demographic and health status of the samples of people with diabetes in ROI and NI. There are no differences (p > 0.05) in the gender and current smoking status of the two samples, the sample from NI is slightly older. As previously reported, people in the NI have significantly lower levels of self-reported good health status and higher rates of education ( 49 ). People with diabetes in NI have substantially more complications related to diabetes; the proportion of people with diabetes and two or more complications is 8.9 percentage points higher (p<0.001) in NI. Rates of stroke, kidney disease and neuropathy are all significantly higher in NI. The number of other chronic diseases that people with diabetes have is also higher in NI; the proportion of people with diabetes, with three or more other chronic conditions is 9.4 percentage points higher (p<0.001) in NI. Chronic lung disease, asthma, arthritis, alcohol or substance abuse, emotional, nervous or psychiatric problems, hypertension and angina are all significantly higher in NI (p < 0.05). In summary, the sample of people with diabetes in NI appear substantially “sicker” than the sample from ROI. [insert Table 1 here] 3.3 Health Care Utilisation Table 2 shows the health care utilisation of people with diabetes in NI and ROI before and after matching. Matching is carried out based on age, sex, education, smoking status, self-related health, number of diabetic complications and number of chronic illnesses. The left hand side of Table 2 shows the health care utilisation of people with diabetes in both jurisdictions before matching. There is no statistical difference between the GP utilisation but outpatient visits; A&E visits and Hospital nights are all significantly higher in NI. Interestingly substantially more people in NI with diabetes reported not having attended their GP in the last year (ROI 4.2%, NI 7.9%, p-value = 0.006). A similar proportion of people with diabetes attended an outpatient service in the past 12 months (ROI 38.9%, NI 38.2%, p-value = 0.79). The right hand side of Table 2 shows the health care utilisation of people with diabetes in both jurisdictions after the matching process. The health care utilisation of the NI group reduced in all areas of utilisation – this is what you would expect as higher needs observations in NI are pruned off in the matching process. After matching for need, the difference between primary care utilisation in ROI and NI is now larger, but still not statistically significant (ROI 5.6, NI 5.0, p-value = 0.108). After matching for need, the difference between secondary care utilisation in ROI and NI is reduced, and in most cases cease to be statistically significant. In the case of inpatient nights however, NI patients continue to consume significantly more care. [insert Table 2 here] Discussion In this study we compare the prevalence, health and patterns of health care usage of people with diabetes in Northern Ireland and the Republic of Ireland based on two samples taken from representative cohort studies in the respective jurisdictions. The surveys show that on an age and gender adjusted basis there is a substantially higher prevalence of diabetes in NI. This contrasts with the previous finding of clinically equivalent prevalence rates of diabetes in NI and ROI across all age groups ( 9 ). The main difference between this study and the previous study ( 9 ) is in the NI prevalence rates. The rates of diabetes shown here for ROI are in line with previous studies for ROI ( 9 , 50 , 51 ). The rates of diabetes shown in the NICOLA data are consistent with the total number of cases of diabetes registered in Northern Ireland ( 7 ). The estimated number of people over 50 with diabetes based on the NICOLA prevalence rates was 67,941 in 2014. This represents 83 per cent of the 81,867 people in NI with a diagnosis of diabetes in the same year on the diabetes register. This is in line with the proportion of people with diabetes who are over 50 in the rest of the UK ( 35 , 36 ). Our results also show that among people with diabetes, those in NI have more complications and more chronic illnesses in general, than people with diabetes in ROI. While it is possible that having a system like QOF may have increased detection and diagnosis of certain conditions, leading to greater prevalence in NI, this is not supported by the lower self-reported health and GP utilisation in the North. Therefore we believe it is not likely that differences in the prevalence of diabetes, diabetic complications and chronic illness can be explained by the differences in the healthcare system between the two jurisdictions. We also find no indication from the data available in the surveys that the higher prevalence rates in NI are due to higher case ascertainment. While alternative data sources for the rates of undiagnosed diabetes in ROI show substantially higher rates compared to TILDA they are still lower than in NI ( 52 ). Broader societal factors, that may include attitudes to diet and physical exercise, other diseases or possibly cumulative lifetime stress may also contribute to the difference in the prevalence rates. There is limited data available that allows for the direct comparison between the two jurisdictions of health indicators relating to diabetes ( 53 , 54 ). From the available data it is not possible to point towards a likely causal mechanism as to why the North would have more diabetes – for example the prevalence of obesity, levels of physical activity and smoking are similar in the two jurisdictions ( 53 ). Chronic stress, related to the protracted period of civil unrest known as the “Troubles” may be one potential explanation for differences ( 55 ) though this is speculative. People with diabetes typically have other chronic conditions ( 56 ). By adjusting for the “sickness” of the people with diabetes in NI and ROI through matching we show that health care utilisation with the exception of inpatient care is similar in both jurisdictions despite differences in health care systems. While not statistically significant, the results point towards a more primary care focused service in ROI, with more frequent GP visits and less frequent secondary care visits. A previous comparison between the two jurisdiction of health care utilisation in general similarly found a greater role played by GPs in ROI ( 57 ). Policies such as QOF and universal access to GP care in NI might be expected to increase health care utilisation in NI, however, this appears not to be the case. While direct financial incentives were not in place at the time in ROI for diabetes care, the higher levels of primary care utilisation seen may relate to the greater availability of GPs in ROI where there are substantially more GPs per capita ( 21 , 22 ). The suite of policies required to improve the supply of GPs goes beyond a narrow set of financial incentives, including increasing GP training intake ( 22 ). The Cycle of Care policy was introduced in ROI in 2015, subsequent to the TILDA data used in this paper. This policy incentivises GPs to provide structured annual reviews and improved records for people with type 2 diabetes. While this may have improved patient care in ROI ( 58 ) any decline in the availability of GPs per capita in the future due to increased demand ( 59 ), or supply factors such as training emigration or retirements ( 22 ) may counteract any positive benefits in the long run. In addition, the Cycle of Care scheme does not provide funding for patients without public medical cover, which comprise 32% of people over 50 years of age with diabetes ( 60 ). It is also notable there is a higher prevalence among people with diabetes in NI of non-attendance at the GP in the past 12 months. As the cut points (proportion of people with diabetes on a practices register) for payments, however, are currently set there are no financial incentives to seek out the people who do not attend once the practice reaches a certain cut off point. This may contribute to poorer disease management and in part explain the greater use of hospital services in Northern Ireland. Higher levels of hospital inpatient utilisation in Northern Ireland may also be due to higher levels of hospital supply ( 61 ). Limitations The data used in this study are based on two large representative cross sectional surveys. However there are a number of limitations to our study. The presence of diabetes, complications, and health care utilisation are all self-reported, running the risk of recall bias. However, there is no reason to believe that recall bias would apply differentially across jurisdictions. The study compares aggregate differences in health care utilisation among those with diabetes and not differences between sub-groups among whom entitlements might differ. While this may provide a fruitful avenue for future research, it was considered to be beyond the scope of this current work. The study considers type 1 and type 2 diabetes together. However the number of people with type 1 diabetes in the surveys is likely to be very small – in the UK less that 4% of people over 50 with diabetes are type 1 ( 35 ). The age and gender adjusted prevalence rates of diabetes and diabetic complications are compared at two time points over three years apart; a comparison of these rates on the same year may reduce or increase the scale of the differences depending on the relative difference in the incidence of diabetes and complications in that three year period. A comparison cannot be made between people with diabetes in the over 85 year old age group as none are present in the TILDA data set. People with dementia are similarly underrepresented in both TILDA and NICOLA. The severity of reported health conditions is not available in the data; the variation in health care needs may not be fully captured by the number of chronic illnesses or the number of diabetic complications. Only key aspects of health care utilisation (general practitioner, outpatient or accident and emergency utilisation) are compared in this study, other primary and social care utilisation are not compared. Conclusion This study shows that the prevalence and severity of diabetes, among those aged 50 and over, is higher in Northern Ireland than in the Republic of Ireland. The study shows that for cohorts with comparable health care needs, with the exception of inpatients nights, there is no significant difference in patterns of health care use. The available data does not allow us to explain the underlining reasons for differences in health care utilisation across the two jurisdictions. For GP utilisation, there are a range of factors including the supply of GPs and financial incentives of both GPs and patients that will affect utilisation. The lack of difference in GP utilisation, despite greater severity, combined with higher rates of GP non-attendance in NI suggest a closer examination of primary care is worthy of investigation. However, it is useful for policy making to know that a substantially different health care system can produce a very similar pattern of utilisation. Abbreviations BMI Body Mass Index CEM Coarsened Exact Matching GP General practitioner QOF Quality and Outcomes framework NI Northern Ireland ROI Republic of Ireland Declarations Ethics approval and consent to participate Ethical approval for the study was obtained from the School of Medicine, Dentistry and Biomedical Sciences Ethics Committee, Queen’s University Belfast. Consent for publication Not applicable. Availability of data and materials The data that support the findings of this study are available on request from TILDA ( https://www.ucd.ie/issda/data/tilda/ ) and NICOLA ( https://www.qub.ac.uk/sites/NICOLA/ ). Competing interests The authors declare no competing interests Funding This project was funded by a grant from the Irish Health Research Board. The funder had no role in the design, collection, analysis, interpretation of data or drafting or approval of the manuscript. Authors' contributions CON, TP and LB contributed to all stages of the study from conception to drafting; AM,LG and SC contributed to the drafting of the manuscript. All authors read and approved the final manuscript. Acknowledgments We are grateful to all the participants of the NICOLA Study, and the whole NICOLA team, which includes nursing staff, research scientists, clerical staff, computer and laboratory technicians, managers and receptionists. The Atlantic Philanthropies, the Economic and Social Research Council, the UKCRC Centre of Excellence for Public Health Northern Ireland, the Centre for Ageing Research and Development in Ireland, the Office of the First Minister and Deputy First Minister, the Health and Social Care Research and Development Division of the Public Health Agency, the Wellcome Trust/Wolfson Foundation and Queen’s University Belfast provide core financial support for NICOLA. The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the authors and do not necessarily represent those of the NICOLA Study team. We are grateful to all the participants of the TILDA Study, and the whole TILDA team, which includes nursing staff, research scientists, clerical staff, computer and laboratory technicians, managers and receptionists. TILDA data may accessed from the following site: Irish Social Science Data Archive (ISSDA) at University College Dublin www.ucd.ie/issda ”.This study has been supported by funding Health Research Board RL/2013/16 for the study’s conduct. References Zhang P, Zhang X, Brown J, Vistisen D, Sicree R, Shaw J, et al. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010;87(3):293-301. O'Neill KN, McHugh SM, Tracey ML, Fitzgerald AP, Kearney PM. Health service utilization and related costs attributable to diabetes. Diabetic Medicine. 2018;35(12):1727-34. Hex N, Bartlett C, Wright D, Taylor M, Varley D. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine. 2012;29(7):855-62. Sortsoe C, Green A, Jensen PB, Emneus M. Societal costs of diabetes mellitus in Denmark. Diabetic Medicine. 2016;33(7):877-85. Kanavos P, Aardweg Svd, Schurer W. Diabetes expenditure, burden of disease and management in 5 EU countries. LSE Health, London School of Economics, 2012. Read SH, Kerssens JJ, McAllister DA, Colhoun HM, Fischbacher CM, Lindsay RS, et al. Trends in type 2 diabetes incidence and mortality in Scotland between 2004 and 2013. Diabetologia. 2016;59(10):2106-13. QOF. 2017/18 raw disease prevalence trend data for Northern Ireland. 2018. Tracey ML, Gilmartin M, O’Neill K, Fitzgerald AP, McHugh SM, Buckley CM, et al. Epidemiology of diabetes and complications among adults in the Republic of Ireland 1998-2015: a systematic review and meta-analysis. BMC public health. 2015;16(1):132. Gallagher N, Bennett K, Smith SM, O’Reilly D. Impact of two different health systems on the burden of type 2 diabetes. Journal of health services research & policy. 2014;19(2):69-76. Roland M, Guthrie B. Quality and Outcomes Framework: what have we learnt? BMJ. 2016;354:i4060. Dept of Health NI. Quality and Outcomes Framework. Belfast: Department of Health NI,, 2017. Gravelle H, Sutton M, Ma A. Doctor behaviour under a pay for performance contract: further evidence from the quality and outcomes framework. 2008. Khunti K, Gadsby R, Millett C, Majeed A, Davies M. Quality of diabetes care in the UK: comparison of published quality‐of‐care reports with results of the Quality and Outcomes Framework for Diabetes. Diabetic medicine. 2007;24(12):1436-41. Galway K, Murphy A, O'Reilly D, O'Dowd T, O'Neill C, Shryane E, et al. Perceived and reported access to the general practitioner: an international comparison of universal access and mixed private/public systems. Irish medical journal. 2007;100(6):494-7. Gettings JV, O’Connor R, O’Doherty J, Hannigan A, Cullen W, Hickey L, et al. A snapshot of type two diabetes mellitus management in general practice prior to the introduction of diabetes Cycle of Care. Irish Journal of Medical Science (1971-). 2018:1-5. Mc Hugh S, O’Keeffe J, Fitzpatrick A, de Siún A, O’Mullane M, Perry I, et al. Diabetes care in Ireland: a survey of general practitioners. Primary Care Diabetes. 2009;3(4):225-31. Wilkinson A, Whitehead L, Ritchie L. Factors influencing the ability to self-manage diabetes for adults living with type 1 or 2 diabetes. International journal of nursing studies. 2014;51(1):111-22. Rushforth B, McCrorie C, Glidewell L, Midgley E, Foy R. Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review. Br J Gen Pract. 2016;66(643):e114-e27. Wolters R, Braspenning J, Wensing M. Impact of primary care on hospital admission rates for diabetes patients: a systematic review. Diabetes research and clinical practice. 2017;129:182-96. Basu S, Berkowitz SA, Phillips RL, Bitton A, Landon BE, Phillips RS. Association of primary care physician supply with population mortality in the United States, 2005-2015. JAMA internal medicine. 2019. NINIS. Belfast: Northern Ireland Neighbourhood Information Service 2018 [cited 2019 03 July]. Available from: http://www.ninis2.nisra.gov.uk/Download/Health%20and%20Social%20Care/GPs,%20Practices%20and%20Registered%20Patients%20(administrative%20geographies).ods . HSE. Medical Workforce Planning: Future Demand for General Practitioners 2015-2025. Dublin: Health Service Executive, 2015. O'Kelly M, Teljeur C, O'Kelly F, Ni Shuilleabhain A, O'Dowd T. Structure of General Practice in Ireland. 2015. Hobbs FR, Bankhead C, Mukhtar T, Stevens S, Perera-Salazar R, Holt T, et al. Clinical workload in UK primary care: a retrospective analysis of 100 million consultations in England, 2007–14. The Lancet. 2016;387(10035):2323-30. Pulse. GP Waiting Times Survey 2017 [08-05-19]. Available from: http://www.pulsetoday.co.uk/your-practice/practice-topics/access/average-gp-waiting-times-remain-at-two-weeks-despite-rescue-measures/20034534.article . NAGP. NAGP Survey: Patient Waiting Times Continue to Increase Due to Under Resourcing 2016. Available from: https://nagp.ie/nagp-survey-patient-waiting-times-continue-to-increase-due-to-under-resourcing/. Maier CB, Aiken LH. Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study. European Journal of Public Health. 2016;26(6):927-34. Teljeur C, Tyrrell E, Kelly A, O’Dowd T, Thomas S. Getting a handle on the general practice workforce in Ireland. Irish journal of medical science. 2014;183(2):207-13. PHA. Northern Ireland General Practice Nursing Workforce Survey Report 2016. Belfast: 2016. Gorecki PK. The Impact of Free GP Care on GP Utilisation in Ireland. The Economic and Social Review. 2018;49(2, Summer):201-15. O'Neill KN, McHugh SM, Kearney PM. Cycle of Care for people with diabetes: an equitable initiative? HRB Open Research. 2019;2. Drummond FJ, O'Leary E, O'Neill C, Burns R, Sharp L. “Bird in the hand” cash was more effective than prize draws in increasing physician questionnaire response. Journal of clinical epidemiology. 2014;67(2):228-31. O'Reilly D, O'Dowd T, Galway KJ, Murphy AW, O'Neill C, Shryane E, et al. Consultation charges in Ireland deter a large proportion of patients from seeing the GP: results of a cross-sectional survey. The European journal of general practice. 2007;13(4):231-6. O’Donnell M, Smyth N, Dinneen S. National Survey of Diabetes Care Delivery in Acute Hospitals 2018. National Clinical Programme for Diabetes 2018. HSCIC. National Diabetes Audit 2012–2013. Report 1: Care Processes and Treatment Targets. Leeds: Health Social Care Information Centre, 2013. NHS Scotland. Scottish Diabetes Survey 2016. Scotland: NHS Scotland,, 2016. Nolan A, Smith S. The effect of differential eligibility for free GP services on GP utilisation in Ireland. Social science & medicine. 2012;74(10):1644-51. Nolan B. The provision and use of health services, health inequalities and health and social gain: ESRI; 2007. Donoghue OA, McGarrigle CA, Kenny RA. The Irish Longitudinal Study on Ageing. In: Gu D, Dupre ME, editors. Encyclopedia of Gerontology and Population Aging. Cham: Springer International Publishing; 2019. p. 1-7. Neville CE, Cruise SM, Burns F. The Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). In: Gu D, Dupre ME, editors. Encyclopedia of Gerontology and Population Aging. Cham: Springer International Publishing; 2019. p. 1-5. NISRA. MID-2017 Population Estimates: Five year age bands and gender: Northern Ireland Statistics and Research Agency; 2018 [cited 2020 May]. Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate behavioral research. 2011;46(3):399-424. Ho DE, Imai K, King G, Stuart EA. Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference. Political analysis. 2007;15(3):199-236. Blackwell M, Iacus S, King G, Porro G. cem: Coarsened exact matching in Stata. The Stata Journal. 2009;9(4):524-46. King G, Nielsen R. Why propensity scores should not be used for matching. Political Analysis. 2016:1-20. McNamara A, Normand C, Whelan B. Patterns and determinants of health care utilisation in Ireland. 2013. Chang H-Y, Weiner JP, Richards TM, Bleich SN, Segal JB. Validating the adapted diabetes complications severity index in claims data. The American journal of managed care. 2012;18(11):721-6. Huntley AL, Johnson R, Purdy S, Valderas JM, Salisbury C. Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide. The Annals of Family Medicine. 2012;10(2):134-41. Cupples ME, Byrne MC, Smith SM, Leathem CS, Murphy AW. Secondary prevention of cardiovascular disease in different primary healthcare systems with and without pay-for-performance. Heart. 2008;94(12):1594-600. Leahy S, O’Halloran A, O’Leary N, Healy M, McCormack M, Kenny R, et al. Prevalence and correlates of diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults: Findings from the Irish Longitudinal Study on Ageing (TILDA). Diabetes research and clinical practice. 2015;110(3):241-9. Balanda KP, Buckley CM, Barron SJ, Fahy LE, Madden JM, Harrington JM, et al. Prevalence of diabetes in the Republic of Ireland: results from the National Health Survey (SLAN) 2007. PloS one. 2013;8(10):e78406. Connor JM, Millar SR, Buckley CM, Kearney PM, Perry IJ. The prevalence and determinants of undiagnosed and diagnosed type 2 diabetes in middle-aged irish adults. PloS one. 2013;8(11):e80504. Ward M, McGee H, Morgan K, Van Lente E, Layte R, Barry MM, et al. SLÁN 2007: survey of lifestyle, attitudes and nutrition in Ireland.‘one Island–one lifestyle?’health and lifestyles in the Republic of Ireland and Northern Ireland: comparing the population surveys SLÁN 2007 and NIHSWS 2005. 2009. Murtagh E, Murphy MH, Murphy NM, Woods C, Lane A. Stay Active: the physical activity, ageing and health study. 2014. O'Neill S, Heenan D, Betts J. Review of Mental Health Policies in Northern Ireland: Making Parity a Reality. 2019. Teljeur C, Smith SM, Paul G, Kelly A, O’Dowd T. Multimorbidity in a cohort of patients with type 2 diabetes. The European journal of general practice. 2013;19(1):17-22. MacGregor P, O’Neill C. Comparing utilisation of health services on the island of Ireland. The provision and use of health services, health inequalities and health and social gain. 2007:90-103. O'Connor R, O'Driscoll R, O'Doherty J, Hannigan A, O'Neill A, Teljeur C, et al. The effect of ‘paying for performance’on the management of type 2 diabetes mellitus: a cross-sectional observational study. BJGP open. 2020. Wren M-A, Keegan C, Walsh B, Bergin A, Eighan J, Brick A, et al. Projections of demand for healthcare in Ireland, 2015-2030: First report from the Hippocrates Model. Dublin: ERSI, 2017. O'Neill KN, McHugh SM, Kearney PM. Cycle of Care for people with diabetes: an equitable initiative? HRB Open Research. 2019;2(3):3. Bengoa R, Stout A, Scott B, McAlinden M, Taylor MA. SYSTEMS, NOT STRUCTURES: CHANGING HEALTH & SOCIAL CARE. Belfast: Expert Panel Report, 2016. Tables Table 1. Health and demogrpahic characterisitcs of older people with diabetes in ROI and NI (before matching) ROI (TILDA) NI (NICOLA) n n p-value Number of People with Diabetes 634 902 Age (Mean) 66.4 67.5 0.018 Male 365 58% 501 56% 0.430 Primary Education Only 260 41% 314 35% 0.014 Current Smoker 109 17% 148 16% 0.685 Good Self Related Health 320 50% 345 38% <0.001 Diabetic Complications None 403 64% 482 53% <0.001 One 167 26% 249 28% 0.58 Two + 64 10% 171 19% <0.001 Heart Attack 73 11.5% 127 14.1% 0.142 Stroke 40 6.3% 87 9.6% 0.020 Leg ulcers 24 3.8% 39 4.3% 0.601 Kidney disease 41 6.5% 129 14.3% <0.001 Neuropathy (Nerve Endings) 90 14.2% 173 19.2% 0.011 Retinopathy 47 7.4% 83 9.2% 0.215 Nephropathy (Kidney) 23 3.6% 74 8.2% <0.001 Treatment Tablets 498 78.5% 678 75.2% 0.124 Insulin 107 16.9% 185 20.5% 0.074 Other Chronic diseases None 113 18% 108 12% 0.001 One 215 34% 280 31% 0.230 Two 188 30% 261 29% 0.760 Three+ 118 19% 253 28% <0.001 Chronic lung disease 30 4.7% 77 8.5% 0.004 Asthma 72 11.4% 134 14.9% 0.048 Arthritis 204 32.2% 382 42.4% <0.001 Osteoporosis 34 5.4% 62 6.9% 0.229 Cancer 46 7.3% 84 9.3% 0.154 Any emotional, nervous or psychiatric problems 63 9.9% 142 15.7% 0.001 Alcohol or substance abuse 14 2.2% 37 4.1% 0.042 Stomach ulcers 47 7.4% 10 1.1% <0.001 Varicose Ulcers 24 3.8% 53 5.9% 0.065 High blood pressure or hypertension 390 61.5% 602 66.7% 0.004 Angina 72 11.4% 143 15.9% 0.048 Table 2. Health care utilisation in the last 12 months by older people with diabetes Before Matching After Matching ROI (TILDA) NI (NICOLA) p-value ROI (TILDA) NI (NICOLA) p-value No. of people with diabetes 634 902 420 486 GP visits per year (mean including non-users) 5.7 5.6 0.668 5.6 5.0 0.108 GP visits: None 4.2% 7.9% 0.004 4.5% 9.3% 0.006 Outpatient visits per year (mean including non-users) 2.1 3.6 <0.001 2.1 3.2 0.079 Outpatient Visits: None 38.9% 38.2% 0.79 40.0% 42.4% 0.47 A&E visits per year (mean including non-users) 0.3 0.5 0.010 0.3 0.4 0.290 Hospital nights per year (mean including non-users) 1.2 2.1 <0.00 1.2 1.8 0.039 Cite Share Download PDF Status: Published Journal Publication published 24 Sep, 2020 Read the published version in BMC Public Health → Version 2 posted Editorial decision: Accept 10 Sep, 2020 Review # 3 received at journal 10 Aug, 2020 Reviewer # 3 agreed at journal 27 Jul, 2020 Review # 1 received at journal 06 Jul, 2020 Review # 2 received at journal 06 Jul, 2020 Reviewer # 1 agreed at journal 22 Jun, 2020 Reviewer # 2 agreed at journal 22 Jun, 2020 Reviewers invited by journal 19 Jun, 2020 Editor assigned by journal 18 Jun, 2020 Submission checks completed at journal 17 Jun, 2020 Editor invited by journal 17 Jun, 2020 You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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In Europe and North America, the proportion of health care expenditure on diabetes in 2010 ranges from 6 to 14 per cent (\u003ca href=\"#_ENREF_1\"\u003e1\u003c/a\u003e). In the Republic of Ireland, the incremental cost of additional health service use is estimated to be \u0026euro;89 million annually (\u003ca href=\"#_ENREF_2\"\u003e2\u003c/a\u003e). Health care utilisation and health care costs among those with diabetes are strongly related to diabetic complications; in the UK, 80 per cent of diabetic health care costs are due to complications (\u003ca href=\"#_ENREF_3\"\u003e3\u003c/a\u003e, \u003ca href=\"#_ENREF_4\"\u003e4\u003c/a\u003e). In addition to direct health care costs, diabetes significantly impacts on mortality rates, quality of life and labour market productivity (\u003ca href=\"#_ENREF_5\"\u003e5\u003c/a\u003e, \u003ca href=\"#_ENREF_6\"\u003e6\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIt is currently difficult to make direct comparisons between the prevalence of diabetes in Northern Ireland (NI) and Republic of Ireland (ROI). In Northern Ireland (NI), based on register data, 5.6% of the population aged 18 and over have diabetes (\u003ca href=\"#_ENREF_7\"\u003e7\u003c/a\u003e). While in ROI a similar register does not exist, it has been estimated that 5.2 per cent of those aged 18 and over have diabetes (\u003ca href=\"#_ENREF_8\"\u003e8\u003c/a\u003e). However, given the strong relationship between diabetes prevalence, age and gender comparing these two figures is problematic. A previous study, based on prescribing databases in the two jurisdictions found clinically equivalent prevalence rates of diabetes in NI and ROI across all age groups (\u003ca href=\"#_ENREF_9\"\u003e9\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eNI and ROI have operate different health care systems. In both, the GP is the primary point of contact between the health service and people with diabetes. However, there are differences in the way that GP services are delivered in NI and ROI. In NI practices provide publicly funded care, free at the point of use, to a defined list of patients on a universal basis. The Quality Outcomes Framework (QOF) system, in place from 2004, provides financial incentives for GPs to maintain disease registers and meet quality indicators. The QOF system resulted in three simultaneous changes: better data collection by GPs, public information on the quality of care, and pay for performance (\u003ca href=\"#_ENREF_10\"\u003e10\u003c/a\u003e). For diabetes, GPs receive additional payment for having higher proportions of patients with biomarkers such as blood pressure, lipids and blood sugar in specified ranges as well as records of screening/examinations (\u003ca href=\"#_ENREF_11\"\u003e11\u003c/a\u003e). However, beyond the upper thresholds of each QOF indicator, GPs receive no additional financial reward to improve care (\u003ca href=\"#_ENREF_12\"\u003e12\u003c/a\u003e). In the UK QOF has been shown to be associated with improvements in both process and outcomes of diabetes care (\u003ca href=\"#_ENREF_13\"\u003e13\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIn ROI, GPs have a mix of publicly funded and private fee paying patients. The mixed nature of GP care in ROI means that GPs who see additional private patients can generate more revenue (\u003ca href=\"#_ENREF_14\"\u003e14\u003c/a\u003e). In contrast in NI, private patients as a potential revenue stream do not exist. In ROI, at the time the data for this study were collected (2011), there was no specific financial support for GPs providing primary care to patients with diabetes. While several diabetes initiatives were in place in Ireland, diabetic care was frequently unstructured and record keeping by many GPs was poor (\u003ca href=\"#_ENREF_15\"\u003e15\u003c/a\u003e, \u003ca href=\"#_ENREF_16\"\u003e16\u003c/a\u003e). However, structured reviews and record keeping are only one component of quality primary care. Access and quality of interaction in GP consultations, continuity of care, and access to practice nurses are important components of care quality (\u003ca href=\"#_ENREF_17\"\u003e17-19\u003c/a\u003e). The supply of GPs has been shown internationally to be associated with improved outcomes, such as reduced mortality (\u003ca href=\"#_ENREF_20\"\u003e20\u003c/a\u003e). In this context it is notable that there are fewer GPs in NI per capita than in ROI;\u0026nbsp; the average GP list size was 1,620 in NI in 2014 (\u003ca href=\"#_ENREF_21\"\u003e21\u003c/a\u003e) and 1,175 in ROI (1,335 based on Whole Time Equivalent, WTE), based on total number (head count) of GPs for 2014 and population numbers (\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e). While we do not have WTE values for GPs in NI, even if all GPs were working on a full time basis in NI, there would still be more supply in ROI. Differences in the supply of GPs may result in shorter consultation durations (\u003ca href=\"#_ENREF_23\"\u003e23\u003c/a\u003e, \u003ca href=\"#_ENREF_24\"\u003e24\u003c/a\u003e) and longer waiting times for non-emergency consultations in NI, as in the rest of the UK (\u003ca href=\"#_ENREF_25\"\u003e25\u003c/a\u003e, \u003ca href=\"#_ENREF_26\"\u003e26\u003c/a\u003e). Practice nurses play an increasingly important role in the provision of primary care (\u003ca href=\"#_ENREF_27\"\u003e27\u003c/a\u003e). \u0026nbsp;As with GPs there are more practice nurses per capita in ROI. In ROI there are 0.26 practice nurses per 1,000, this compares with an average of 0.2 in NI (\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e, \u003ca href=\"#_ENREF_28\"\u003e28\u003c/a\u003e, \u003ca href=\"#_ENREF_29\"\u003e29\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eCost has been shown to be an important factor in the demand for GP care (\u003ca href=\"#_ENREF_30\"\u003e30\u003c/a\u003e). While GP care is free at the point of use for patients in Northern Ireland, a substantial minority (31.5%) of people in ROI with diabetes are not covered by the medical card or GP visit card schemes and will have to pay for their GP care (\u003ca href=\"#_ENREF_31\"\u003e31\u003c/a\u003e). For those who have to pay out of pocket for a GP consultation, the cost of a consultation is in the region of \u0026euro;50, which may represent a significant deterrent to attending (\u003ca href=\"#_ENREF_32\"\u003e32\u003c/a\u003e, \u003ca href=\"#_ENREF_33\"\u003e33\u003c/a\u003e). While the cost of attending the GP may be a deterrent for some people it may, by reducing demand, reduce capacity constraints that permit easier access for others (\u003ca href=\"#_ENREF_14\"\u003e14\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eThe approach to outpatient diabetes care varies widely across public hospitals in ROI in terms of the discharging of uncomplicated cases back to primary care (\u003ca href=\"#_ENREF_34\"\u003e34\u003c/a\u003e). There is also substantial variation in waiting lists across hospitals for outpatient care. All patients have access to free public outpatient diabetes care but non-medical card holders (those who have to pay to access GP care) usually have to pay for diabetes services provided by their GP (\u003ca href=\"#_ENREF_34\"\u003e34\u003c/a\u003e). This can result in a reluctance by some patients to be discharged to their GP (\u003ca href=\"#_ENREF_34\"\u003e34\u003c/a\u003e). There is no costs to patients for attending outpatient clinics in NI. Outpatient waiting lists are not available for diabetes care.\u003c/p\u003e\n\u003cp\u003eIn this study, we examine, for patients aged 50 and over with diabetes, differences between NI and ROI in the prevalence of diabetes and the number and type of health care contacts (GP, Outpatient, A\u0026amp;E Visits and Hospital Nights). Older people are the main population of interest for examining health care utilisation by people with diabetes given this is where the disease is most prevalent \u0026ndash; in the UK, 83 per cent of people with diabetes (type I and type II) are over the age of 50 (\u003ca href=\"#_ENREF_35\"\u003e35\u003c/a\u003e, \u003ca href=\"#_ENREF_36\"\u003e36\u003c/a\u003e). One previous study, using different data sources, has previously compared the age adjusted prevalence of diabetes between the two jurisdictions. Differences in entitlement to care (including sub-groups differentiated by income level) and utilization of care between the two parts of Ireland have been explored previously for the overall population (\u003ca href=\"#_ENREF_33\"\u003e33\u003c/a\u003e, \u003ca href=\"#_ENREF_37\"\u003e37\u003c/a\u003e, \u003ca href=\"#_ENREF_38\"\u003e38\u003c/a\u003e). As far at the authors are aware a needs adjusted comparison of health care utilisation by people with diabetes is not available.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eData\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe Irish Longitudinal Study on Aging (TILDA) and Northern Irish Cohort for the Longitudinal Study of Aging (NICOLA) surveys, used in this study, are based on interviews and health assessments with a representative of the population aged 50 and over in both ROI and NI (see (\u003ca href=\"#_ENREF_39\"\u003e39\u003c/a\u003e) and (\u003ca href=\"#_ENREF_40\"\u003e40\u003c/a\u003e) for further details of the TILDA and NICOLA studies, including design, methodology, and assessments carried out). The health assessment comprised of a physical examination and a blood test carried out by a nurse at a health centre.\u003c/p\u003e\n\u003cp\u003eThe TILDA and NICOLA surveys are ideally designed for comparison with each other due to the similarity in the two surveys. Each survey consists of computer-assisted personal interviewing (CAPI) surveys containing identical questions on diabetes diagnosis and complications. Self-reported doctor diagnosed diabetes, directly comparable across the two surveys, is used in this study. The prevalence of diabetes is compared for age groups between 50 and 84 as there are no observations with diabetes over the age of 84 in the TILDA data. Self-reported health care utilisation variables examined in this study were GP utilisation, outpatient, A\u0026amp;E and hospital nights. Utilisation rates are all based on the previous 12 months. Survey work for TILDA was carried out in 2011 (Wave 1), survey work for NICOLA was carried out in 2014-2016 (Wave 1). Using the first wave of each survey is advantageous as attrition in later waves may not be at random. Estimates of the number of cases of diabetes in NI are based on NICOLA age and gender adusted prevalence rates and population estimates for 2014 (\u003ca href=\"#_ENREF_41\"\u003e41\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical Approach \u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMatching is a method for rebalancing observational data (\u003ca href=\"#_ENREF_42\"\u003e42\u003c/a\u003e). A key advantage of matching over regression analysis is a reduced dependence on assumptions about functional form (\u003ca href=\"#_ENREF_43\"\u003e43\u003c/a\u003e). A Coarsened Exact Matching (CEM) approach is used here to match observations in the two jurisdictions and allow for a direct comparison of outcomes. CEM is a type of matching process that involves the temporary coarsening of continuous variables followed by a direct matching between two groups. The CEM method involves categorising continuous variables into user defined groups. A stratum is created for each unique observation in the data set. Observations are dropped that do not have at least one observation from the two groups in the stratum. Thus, the CEM process involves pruning from both groups (\u003ca href=\"#_ENREF_44\"\u003e44\u003c/a\u003e). This method was chosen over the Mahalanobis distance method of matching as we wish to match on a combination of continuous and dichotomous variables (\u003ca href=\"#_ENREF_45\"\u003e45\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMatching Variables\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMatching is done based on the presence and severity of health needs. Health needs are captured in age, sex, education, current smoking status, self-reported health, the number of chronic illnesses and the number of diabetic complications reported. Diabetic complications are defined here as heart attack, stroke, leg ulcers, kidney disease, neuropathy, retinopathy and nephropathy. These matching variables were selected based on previous findings from TILDA of the covariates of health care utilisation (\u003ca href=\"#_ENREF_46\"\u003e46\u003c/a\u003e). A count of the number of diabetic complications is included as this has been shown to correlate with hospital utilisation (\u003ca href=\"#_ENREF_47\"\u003e47\u003c/a\u003e). Similarly, chronic illnesses identified in the surveys were included in the matching as a count as there is little indication that more complex multi-morbidity indexes outperform a simple count (\u003ca href=\"#_ENREF_48\"\u003e48\u003c/a\u003e). The available chronic illness in the surveys are: chronic lung disease; asthma; arthritis; osteoporosis; cancer; any emotional, nervous or psychiatric problems; alcohol or substance abuse; stomach ulcers; varicose ulcers; high blood pressure or hypertension and angina. Body Mass Index (BMI), glycosylated haemoglobin (HbA1c) and other biometric markers are not included in the analysis of health care utilisation as they are only available for the subsample that attended the health assessment.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNumber of Observations\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn total 17,008 people were surveyed (TILDA: 8,504 and NICOLA: 8,504). Both studies contain a small number of observations under 50 years included in the matching process (TILDA: 329 and NICOLA: 195). There were 16,681 observations (TILDA: 8,468 and NICOLA: 8,212) with no missing data in the matching and outcome variables. The combined data set comprises complete surveys from 1,536 people with diabetes (TILDA: 634 and NICOLA: 902). After the matching process there are a total of 906 observations (TILDA: 420 and NICOLA: 486).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003e3.1 Prevalence of Diabetes\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFigure 1 shows the percentage of individuals who report having received a diagnosis of diabetes from their doctor by sex and age group in NI and ROI. The prevalence rates for NI are higher across all age groups and genders. The overall prevalence in the 50 to 84 years old age group is 3.4 percentage points higher in NI (11.1% in NI, 7.7% ROI, p-value \u0026lt; 0.01). There are no observations in ROI for those in the over 85 years age group.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;[INSERT FIGURE 1 HERE]\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere is no indication from the data available that the higher prevalence rates in NI are due to higher case ascertainment. Among those for whom HbA1c data were available, the rates of undiagnosed\u0026nbsp; diabetes (HbA1c \u0026gt; 48 mmol/mol (6.5 %) and no report of a diabetes diagnosis) are also higher in NI(0.8% in ROI vs 4.4% in NI).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.2 Health of People with Diabetes\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTable 1 shows the demographic and health status of the samples of people with diabetes in ROI and NI. There are no differences (p \u0026gt; 0.05) in the gender and current smoking status of the two samples, the sample from NI is slightly older. As previously reported, people in the NI have significantly lower levels of self-reported good health status and higher rates of education (\u003ca href=\"#_ENREF_49\"\u003e49\u003c/a\u003e). People with diabetes in NI have substantially more complications related to diabetes; the proportion of people with diabetes and two or more complications is 8.9 percentage points higher (p\u0026lt;0.001) in NI. Rates of stroke, kidney disease and neuropathy are all significantly higher in NI. The number of other chronic diseases that people with diabetes have is also higher in NI; the proportion of people with diabetes, with three or more other chronic conditions is 9.4 percentage points higher (p\u0026lt;0.001) in NI. Chronic lung disease, asthma, arthritis, alcohol or substance abuse, emotional, nervous or psychiatric problems, hypertension and angina are all significantly higher in NI (p \u0026lt; 0.05). In summary, the sample of people with diabetes in NI appear substantially \u0026ldquo;sicker\u0026rdquo; than the sample from ROI.\u003c/p\u003e\n\u003cp\u003e[insert Table 1 here]\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.3 Health Care Utilisation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 shows the health care utilisation of people with diabetes in NI and ROI before and after matching. Matching is carried out based on age, sex, education, smoking status, self-related health, number of diabetic complications and number of chronic illnesses. The left hand side of Table 2 shows the health care utilisation of people with diabetes in both jurisdictions before matching. There is no statistical difference between the GP utilisation but outpatient visits; A\u0026amp;E visits and Hospital nights are all significantly higher in NI. Interestingly substantially more people in NI with diabetes reported not having attended their GP in the last year (ROI 4.2%, NI 7.9%, p-value = 0.006). A similar proportion of people with diabetes attended an outpatient service in the past 12 months (ROI 38.9%, NI 38.2%, p-value = 0.79).\u003c/p\u003e\n\u003cp\u003eThe right hand side of Table 2 shows the health care utilisation of people with diabetes in both jurisdictions after the matching process. The health care utilisation of the NI group reduced in all areas of utilisation \u0026ndash; this is what you would expect as higher needs observations in NI are pruned off in the matching process. After matching for need, the difference between primary care utilisation in ROI and NI is now larger, but still not statistically significant (ROI 5.6, NI 5.0, p-value = 0.108). After matching for need, the difference between secondary care utilisation in ROI and NI is reduced, and in most cases cease to be statistically significant. In the case of inpatient nights however, NI patients continue to consume significantly more care.\u003c/p\u003e\n\u003cp\u003e[insert Table 2 here]\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study we compare the prevalence, health and patterns of health care usage of people with diabetes in Northern Ireland and the Republic of Ireland based on two samples taken from representative cohort studies in the respective jurisdictions.\u003c/p\u003e\n\u003cp\u003eThe surveys show that on an age and gender adjusted basis there is a substantially higher prevalence of diabetes in NI. This contrasts with the previous finding of clinically equivalent prevalence rates of diabetes in NI and ROI across all age groups (\u003ca href=\"#_ENREF_9\"\u003e9\u003c/a\u003e). The main difference between this study and the previous study (\u003ca href=\"#_ENREF_9\"\u003e9\u003c/a\u003e) is in the NI prevalence rates. The rates of diabetes shown here for ROI are in line with previous studies for ROI (\u003ca href=\"#_ENREF_9\"\u003e9\u003c/a\u003e, \u003ca href=\"#_ENREF_50\"\u003e50\u003c/a\u003e, \u003ca href=\"#_ENREF_51\"\u003e51\u003c/a\u003e). The rates of diabetes shown in the NICOLA data are consistent with the total number of cases of diabetes registered in Northern Ireland (\u003ca href=\"#_ENREF_7\"\u003e7\u003c/a\u003e). The estimated number of people over 50 with diabetes based on the NICOLA prevalence rates was 67,941 in 2014. This represents 83 per cent of the 81,867 people in NI with a diagnosis of diabetes in the same year on the diabetes register. This is in line with the proportion of people with diabetes who are over 50 in the rest of the UK (\u003ca href=\"#_ENREF_35\"\u003e35\u003c/a\u003e, \u003ca href=\"#_ENREF_36\"\u003e36\u003c/a\u003e). Our results also show that among people with diabetes, those in NI have more complications and more chronic illnesses in general, than people with diabetes in ROI.\u003c/p\u003e\n\u003cp\u003eWhile it is possible that having a system like QOF may have increased detection and diagnosis of certain conditions, leading to greater prevalence in NI, this is not supported by the lower self-reported health and GP utilisation in the North. Therefore we believe it is not likely that differences in the prevalence of diabetes, diabetic complications and chronic illness can be explained by the differences in the healthcare system between the two jurisdictions. We also find no indication from the data available in the surveys that the higher prevalence rates in NI are due to higher case ascertainment. While alternative data sources for the rates of undiagnosed diabetes in ROI show substantially higher rates compared to TILDA they are still lower than in NI (\u003ca href=\"#_ENREF_52\"\u003e52\u003c/a\u003e). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBroader societal factors, that may include attitudes to diet and physical exercise, other diseases or possibly cumulative lifetime stress may also contribute to the difference in the prevalence rates. There is limited data available that allows for the direct comparison between the two jurisdictions of health indicators relating to diabetes (\u003ca href=\"#_ENREF_53\"\u003e53\u003c/a\u003e, \u003ca href=\"#_ENREF_54\"\u003e54\u003c/a\u003e). From the available data it is not possible to point towards a likely causal mechanism as to why the North would have more diabetes \u0026ndash; for example the prevalence of obesity, levels of physical activity and smoking are similar in the two jurisdictions (\u003ca href=\"#_ENREF_53\"\u003e53\u003c/a\u003e). Chronic stress, related to the protracted period of civil unrest known as the \u0026ldquo;Troubles\u0026rdquo; may be one potential explanation for differences (\u003ca href=\"#_ENREF_55\"\u003e55\u003c/a\u003e) though this is speculative.\u003c/p\u003e\n\u003cp\u003ePeople with diabetes typically have other chronic conditions (\u003ca href=\"#_ENREF_56\"\u003e56\u003c/a\u003e). By adjusting for the \u0026ldquo;sickness\u0026rdquo; of the people with diabetes in NI and ROI through matching we show that health care utilisation with the exception of inpatient care is similar in both jurisdictions despite differences in health care systems. While not statistically significant, the results point towards a more primary care focused service in ROI, with more frequent GP visits and less frequent secondary care visits. A previous comparison between the two jurisdiction of health care utilisation in general similarly found a greater role played by GPs in ROI (\u003ca href=\"#_ENREF_57\"\u003e57\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003ePolicies such as QOF and universal access to GP care in NI might be expected to increase health care utilisation in NI, however, this appears not to be the case. While direct financial incentives were not in place at the time in ROI for diabetes care, the higher levels of primary care utilisation seen may relate to the greater availability of GPs in ROI where there are substantially more GPs per capita (\u003ca href=\"#_ENREF_21\"\u003e21\u003c/a\u003e, \u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e). The suite of policies required to improve the supply of GPs goes beyond a narrow set of financial incentives, including increasing GP training intake (\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e). The Cycle of Care policy was introduced in ROI in 2015, subsequent to the TILDA data used in this paper. This policy incentivises GPs to provide structured annual reviews and improved records for people with type 2 diabetes. While this may have improved patient care in ROI (\u003ca href=\"#_ENREF_58\"\u003e58\u003c/a\u003e) any decline in the availability of GPs per capita in the future due to increased demand (\u003ca href=\"#_ENREF_59\"\u003e59\u003c/a\u003e), or supply factors such as training emigration or retirements (\u003ca href=\"#_ENREF_22\"\u003e22\u003c/a\u003e) may counteract any positive benefits in the long run. In addition, the Cycle of Care scheme does not provide funding for patients without public medical cover, which comprise 32% of people over 50 years of age with diabetes (\u003ca href=\"#_ENREF_60\"\u003e60\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eIt is also notable there is a higher prevalence among people with diabetes in NI of non-attendance at the GP in the past 12 months. As the cut points (proportion of people with diabetes on a practices register) for payments, however, are currently set there are no financial incentives to seek out the people who do not attend once the practice reaches a certain cut off point. This may contribute to poorer disease management and in part explain the greater use of hospital services in Northern Ireland.\u0026nbsp; Higher levels of hospital inpatient utilisation in Northern Ireland may also be due to higher levels of hospital supply (\u003ca href=\"#_ENREF_61\"\u003e61\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThe data used in this study are based on two large representative cross sectional surveys. However there are a number of limitations to our study. The presence of diabetes, complications, and health care utilisation are all self-reported, running the risk of recall bias. However, there is no reason to believe that recall bias would apply differentially across jurisdictions. The study compares aggregate differences in health care utilisation among those with diabetes and not differences between sub-groups among whom entitlements might differ. While this may provide a fruitful avenue for future research, it was considered to be beyond the scope of this current work. The study considers type 1 and type 2 diabetes together. However the number of people with type 1 diabetes in the surveys is likely to be very small \u0026ndash; in the UK less that 4% of people over 50 with diabetes are type 1 (\u003ca href=\"#_ENREF_35\"\u003e35\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003eThe age and gender adjusted prevalence rates of diabetes and diabetic complications are compared at two time points over three years apart; a comparison of these rates on the same year may reduce or increase the scale of the differences depending on the relative difference in the incidence of diabetes and complications in that three year period. A comparison cannot be made between people with diabetes in the over 85 year old age group as none are present in the TILDA data set. People with dementia are similarly underrepresented in both TILDA and NICOLA. The severity of reported health conditions is not available in the data; the variation in health care needs may not be fully captured by the number of chronic illnesses or the number of diabetic complications. Only key aspects of health care utilisation (general practitioner, outpatient or accident and emergency utilisation) are compared in this study, other primary and social care utilisation are not compared.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study shows that the prevalence and severity of diabetes, among those aged 50 and over, is higher in Northern Ireland than in the Republic of Ireland. The study shows that for cohorts with comparable health care needs, with the exception of inpatients nights, there is no significant difference in patterns of health care use. The available data does not allow us to explain the underlining reasons for differences in health care utilisation across the two jurisdictions. For GP utilisation, there are a range of factors including the supply of GPs and financial incentives of both GPs and patients that will affect utilisation. The lack of difference in GP utilisation, despite greater severity, combined with higher rates of GP non-attendance in NI suggest a closer examination of primary care is worthy of investigation. However, it is useful for policy making to know that a substantially different health care system can produce a very similar pattern of utilisation.\u003c/p\u003e"},{"header":"Abbreviations","content":" \u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBMI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBody Mass Index\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCEM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCoarsened Exact Matching\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGeneral practitioner\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eQOF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eQuality and Outcomes framework\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNorthern Ireland\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eROI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRepublic of Ireland\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for the study was obtained from the School of Medicine, Dentistry and Biomedical Sciences Ethics Committee, Queen\u0026rsquo;s University Belfast.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available on request from TILDA (\u003ca href=\"https://www.ucd.ie/issda/data/tilda/\"\u003ehttps://www.ucd.ie/issda/data/tilda/\u003c/a\u003e) and NICOLA (\u003ca href=\"https://www.qub.ac.uk/sites/NICOLA/\"\u003ehttps://www.qub.ac.uk/sites/NICOLA/\u003c/a\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis project was funded by a grant from the Irish Health Research Board. The funder had no role in the design, collection, analysis, interpretation of data or drafting or approval of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCON, TP and LB contributed to all stages of the study from conception to drafting; AM,LG and SC contributed to the drafting of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful to all the participants of the NICOLA Study, and the whole NICOLA team, which includes nursing staff, research scientists, clerical staff, computer and laboratory technicians, managers and receptionists. The Atlantic Philanthropies, the Economic and Social Research Council, the UKCRC Centre of Excellence for Public Health Northern Ireland, the Centre for Ageing Research and Development in Ireland, the Office of the First Minister and Deputy First Minister, the Health and Social Care Research and Development Division of the Public Health Agency, the Wellcome Trust/Wolfson Foundation and Queen\u0026rsquo;s University Belfast provide core financial support for NICOLA. The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the authors and do not necessarily represent those of the NICOLA Study team. We are grateful to all the participants of the TILDA Study, and the whole TILDA team, which includes nursing staff, research scientists, clerical staff, computer and laboratory technicians, managers and receptionists. TILDA data may accessed from the following site: Irish Social Science Data Archive (ISSDA) at University College Dublin \u003ca href=\"http://www.ucd.ie/issda\"\u003ewww.ucd.ie/issda\u003c/a\u003e\u0026rdquo;.This study has been supported by funding Health Research Board RL/2013/16 for the study\u0026rsquo;s conduct.\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e Zhang P, Zhang X, Brown J, Vistisen D, Sicree R, Shaw J, et al. Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes research and clinical practice. 2010;87(3):293-301.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e O'Neill KN, McHugh SM, Tracey ML, Fitzgerald AP, Kearney PM. Health service utilization and related costs attributable to diabetes. Diabetic Medicine. 2018;35(12):1727-34.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Hex N, Bartlett C, Wright D, Taylor M, Varley D. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine. 2012;29(7):855-62.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Sortsoe C, Green A, Jensen PB, Emneus M. Societal costs of diabetes mellitus in Denmark. Diabetic Medicine. 2016;33(7):877-85.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Kanavos P, Aardweg Svd, Schurer W. Diabetes expenditure, burden of disease and management in 5 EU countries. LSE Health, London School of Economics, 2012.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Read SH, Kerssens JJ, McAllister DA, Colhoun HM, Fischbacher CM, Lindsay RS, et al. Trends in type 2 diabetes incidence and mortality in Scotland between 2004 and 2013. Diabetologia. 2016;59(10):2106-13.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e QOF. 2017/18 raw disease prevalence trend data for Northern Ireland. 2018.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Tracey ML, Gilmartin M, O\u0026rsquo;Neill K, Fitzgerald AP, McHugh SM, Buckley CM, et al. Epidemiology of diabetes and complications among adults in the Republic of Ireland 1998-2015: a systematic review and meta-analysis. BMC public health. 2015;16(1):132.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Gallagher N, Bennett K, Smith SM, O\u0026rsquo;Reilly D. Impact of two different health systems on the burden of type 2 diabetes. Journal of health services research \u0026amp; policy. 2014;19(2):69-76.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Roland M, Guthrie B. Quality and Outcomes Framework: what have we learnt? BMJ. 2016;354:i4060.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Dept of Health NI. Quality and Outcomes Framework. Belfast: Department of Health NI,, 2017.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Gravelle H, Sutton M, Ma A. Doctor behaviour under a pay for performance contract: further evidence from the quality and outcomes framework. 2008.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Khunti K, Gadsby R, Millett C, Majeed A, Davies M. Quality of diabetes care in the UK: comparison of published quality‐of‐care reports with results of the Quality and Outcomes Framework for Diabetes. Diabetic medicine. 2007;24(12):1436-41.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Galway K, Murphy A, O'Reilly D, O'Dowd T, O'Neill C, Shryane E, et al. Perceived and reported access to the general practitioner: an international comparison of universal access and mixed private/public systems. Irish medical journal. 2007;100(6):494-7.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Gettings JV, O\u0026rsquo;Connor R, O\u0026rsquo;Doherty J, Hannigan A, Cullen W, Hickey L, et al. A snapshot of type two diabetes mellitus management in general practice prior to the introduction of diabetes Cycle of Care. Irish Journal of Medical Science (1971-). 2018:1-5.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Mc Hugh S, O\u0026rsquo;Keeffe J, Fitzpatrick A, de Si\u0026uacute;n A, O\u0026rsquo;Mullane M, Perry I, et al. Diabetes care in Ireland: a survey of general practitioners. Primary Care Diabetes. 2009;3(4):225-31.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Wilkinson A, Whitehead L, Ritchie L. Factors influencing the ability to self-manage diabetes for adults living with type 1 or 2 diabetes. International journal of nursing studies. 2014;51(1):111-22.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Rushforth B, McCrorie C, Glidewell L, Midgley E, Foy R. Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review. Br J Gen Pract. 2016;66(643):e114-e27.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Wolters R, Braspenning J, Wensing M. Impact of primary care on hospital admission rates for diabetes patients: a systematic review. Diabetes research and clinical practice. 2017;129:182-96.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Basu S, Berkowitz SA, Phillips RL, Bitton A, Landon BE, Phillips RS. Association of primary care physician supply with population mortality in the United States, 2005-2015. JAMA internal medicine. 2019.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e NINIS. Belfast: Northern Ireland Neighbourhood Information Service 2018 [cited 2019 03 July]. Available from: \u003c/strong\u003e\u003ca href=\"http://www.ninis2.nisra.gov.uk/Download/Health%20and%20Social%20Care/GPs,%20Practices%20and%20Registered%20Patients%20(administrative%20geographies).ods\"\u003e\u003cstrong\u003ehttp://www.ninis2.nisra.gov.uk/Download/Health%20and%20Social%20Care/GPs,%20Practices%20and%20Registered%20Patients%20(administrative%20geographies).ods\u003c/strong\u003e\u003c/a\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e HSE. Medical Workforce Planning: Future Demand for General Practitioners 2015-2025. Dublin: Health Service Executive, 2015.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e O'Kelly M, Teljeur C, O'Kelly F, Ni Shuilleabhain A, O'Dowd T. Structure of General Practice in Ireland. 2015.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Hobbs FR, Bankhead C, Mukhtar T, Stevens S, Perera-Salazar R, Holt T, et al. Clinical workload in UK primary care: a retrospective analysis of 100 million consultations in England, 2007\u0026ndash;14. The Lancet. 2016;387(10035):2323-30.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Pulse. GP Waiting Times Survey 2017 [08-05-19]. Available from: \u003c/strong\u003e\u003ca href=\"http://www.pulsetoday.co.uk/your-practice/practice-topics/access/average-gp-waiting-times-remain-at-two-weeks-despite-rescue-measures/20034534.article\"\u003e\u003cstrong\u003ehttp://www.pulsetoday.co.uk/your-practice/practice-topics/access/average-gp-waiting-times-remain-at-two-weeks-despite-rescue-measures/20034534.article\u003c/strong\u003e\u003c/a\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e NAGP. NAGP Survey: Patient Waiting Times Continue to Increase Due to Under Resourcing 2016. Available from: https://nagp.ie/nagp-survey-patient-waiting-times-continue-to-increase-due-to-under-resourcing/.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Maier CB, Aiken LH. Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study. European Journal of Public Health. 2016;26(6):927-34.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Teljeur C, Tyrrell E, Kelly A, O\u0026rsquo;Dowd T, Thomas S. Getting a handle on the general practice workforce in Ireland. Irish journal of medical science. 2014;183(2):207-13.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e PHA. Northern Ireland General Practice Nursing Workforce Survey Report 2016. Belfast: 2016.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Gorecki PK. The Impact of Free GP Care on GP Utilisation in Ireland. The Economic and Social Review. 2018;49(2, Summer):201-15.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e O'Neill KN, McHugh SM, Kearney PM. Cycle of Care for people with diabetes: an equitable initiative? HRB Open Research. 2019;2.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Drummond FJ, O'Leary E, O'Neill C, Burns R, Sharp L. \u0026ldquo;Bird in the hand\u0026rdquo; cash was more effective than prize draws in increasing physician questionnaire response. Journal of clinical epidemiology. 2014;67(2):228-31.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e O'Reilly D, O'Dowd T, Galway KJ, Murphy AW, O'Neill C, Shryane E, et al. Consultation charges in Ireland deter a large proportion of patients from seeing the GP: results of a cross-sectional survey. The European journal of general practice. 2007;13(4):231-6.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e O\u0026rsquo;Donnell M, Smyth N, Dinneen S. National Survey of Diabetes Care Delivery in Acute Hospitals 2018. National Clinical Programme for Diabetes 2018.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e HSCIC. National Diabetes Audit 2012\u0026ndash;2013. Report 1: Care Processes and Treatment Targets. Leeds: Health Social Care Information Centre, 2013.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e NHS Scotland. Scottish Diabetes Survey 2016. Scotland: NHS Scotland,, 2016.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Nolan A, Smith S. The effect of differential eligibility for free GP services on GP utilisation in Ireland. Social science \u0026amp; medicine. 2012;74(10):1644-51.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Nolan B. The provision and use of health services, health inequalities and health and social gain: ESRI; 2007.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Donoghue OA, McGarrigle CA, Kenny RA. The Irish Longitudinal Study on Ageing. In: Gu D, Dupre ME, editors. Encyclopedia of Gerontology and Population Aging. Cham: Springer International Publishing; 2019. p. 1-7.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Neville CE, Cruise SM, Burns F. The Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). In: Gu D, Dupre ME, editors. Encyclopedia of Gerontology and Population Aging. Cham: Springer International Publishing; 2019. p. 1-5.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e NISRA. MID-2017 Population Estimates: Five year age bands and gender: Northern Ireland Statistics and Research Agency; 2018 [cited 2020 May].\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate behavioral research. 2011;46(3):399-424.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Ho DE, Imai K, King G, Stuart EA. Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference. Political analysis. 2007;15(3):199-236.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Blackwell M, Iacus S, King G, Porro G. cem: Coarsened exact matching in Stata. The Stata Journal. 2009;9(4):524-46.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e King G, Nielsen R. Why propensity scores should not be used for matching. Political Analysis. 2016:1-20.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e McNamara A, Normand C, Whelan B. Patterns and determinants of health care utilisation in Ireland. 2013.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Chang H-Y, Weiner JP, Richards TM, Bleich SN, Segal JB. Validating the adapted diabetes complications severity index in claims data. The American journal of managed care. 2012;18(11):721-6.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Huntley AL, Johnson R, Purdy S, Valderas JM, Salisbury C. Measures of multimorbidity and morbidity burden for use in primary care and community settings: a systematic review and guide. The Annals of Family Medicine. 2012;10(2):134-41.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Cupples ME, Byrne MC, Smith SM, Leathem CS, Murphy AW. Secondary prevention of cardiovascular disease in different primary healthcare systems with and without pay-for-performance. Heart. 2008;94(12):1594-600.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Leahy S, O\u0026rsquo;Halloran A, O\u0026rsquo;Leary N, Healy M, McCormack M, Kenny R, et al. Prevalence and correlates of diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults: Findings from the Irish Longitudinal Study on Ageing (TILDA). Diabetes research and clinical practice. 2015;110(3):241-9.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Balanda KP, Buckley CM, Barron SJ, Fahy LE, Madden JM, Harrington JM, et al. Prevalence of diabetes in the Republic of Ireland: results from the National Health Survey (SLAN) 2007. PloS one. 2013;8(10):e78406.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Connor JM, Millar SR, Buckley CM, Kearney PM, Perry IJ. The prevalence and determinants of undiagnosed and diagnosed type 2 diabetes in middle-aged irish adults. PloS one. 2013;8(11):e80504.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Ward M, McGee H, Morgan K, Van Lente E, Layte R, Barry MM, et al. SL\u0026Aacute;N 2007: survey of lifestyle, attitudes and nutrition in Ireland.\u0026lsquo;one Island\u0026ndash;one lifestyle?\u0026rsquo;health and lifestyles in the Republic of Ireland and Northern Ireland: comparing the population surveys SL\u0026Aacute;N 2007 and NIHSWS 2005. 2009.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Murtagh E, Murphy MH, Murphy NM, Woods C, Lane A. Stay Active: the physical activity, ageing and health study. 2014.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e O'Neill S, Heenan D, Betts J. Review of Mental Health Policies in Northern Ireland: Making Parity a Reality. 2019.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Teljeur C, Smith SM, Paul G, Kelly A, O\u0026rsquo;Dowd T. Multimorbidity in a cohort of patients with type 2 diabetes. The European journal of general practice. 2013;19(1):17-22.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e MacGregor P, O\u0026rsquo;Neill C. Comparing utilisation of health services on the island of Ireland. The provision and use of health services, health inequalities and health and social gain. 2007:90-103.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e O'Connor R, O'Driscoll R, O'Doherty J, Hannigan A, O'Neill A, Teljeur C, et al. The effect of \u0026lsquo;paying for performance\u0026rsquo;on the management of type 2 diabetes mellitus: a cross-sectional observational study. BJGP open. 2020.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Wren M-A, Keegan C, Walsh B, Bergin A, Eighan J, Brick A, et al. Projections of demand for healthcare in Ireland, 2015-2030: First report from the Hippocrates Model. Dublin: ERSI, 2017.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e O'Neill KN, McHugh SM, Kearney PM. Cycle of Care for people with diabetes: an equitable initiative? HRB Open Research. 2019;2(3):3.\u003c/strong\u003e\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003e Bengoa R, Stout A, Scott B, McAlinden M, Taylor MA. SYSTEMS, NOT STRUCTURES: CHANGING HEALTH \u0026amp; SOCIAL CARE. Belfast: Expert Panel Report, 2016.\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Tables","content":"\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10px; line-height: 115%; color: rgb(0, 0, 0); font-family: Verdana, Geneva, sans-serif;\"\u003eTable 1. Health and demogrpahic characterisitcs of older people with diabetes in ROI and NI \u0026nbsp;(before matching)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\" style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\n \u003ctable style=\"width:393.7pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 85pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eROI (TILDA)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 103.5pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eNI (NICOLA)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 49.65pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 50.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58.95pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 49.65pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNumber of People with Diabetes\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e634\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e902\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAge (Mean)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e66.4\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e67.5\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.018\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 13.35pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eMale\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 13.35pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e365\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e58%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 13.35pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e501\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e56%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.35pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.430\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 14.3pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePrimary Education Only\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.3pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e260\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:14.3pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e41%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 14.3pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e314\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:14.3pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e35%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:14.3pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.014\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 13.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eCurrent Smoker\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 13.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e109\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e17%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 13.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e148\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e16%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:13.75pt;\"\u003e\n \u003cp 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rgb(0, 0, 0);\"\u003eGood Self Related Health\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e320\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e50%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e345\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e38%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 12.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eDiabetic Complications\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 12.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:12.75pt;\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 12.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:12.75pt;\"\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cbr\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:12.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n 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style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e403\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e64%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e482\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e53%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eOne\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e167\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e26%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e249\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e28%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.58\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTwo +\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n 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15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e73\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 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style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9.6%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 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bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e24\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 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style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.3%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.601\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eKidney disease\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e41\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6.5%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e129\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14.3%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNeuropathy (Nerve Endings)\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e90\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e173\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e19.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.011\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eRetinopathy\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e47\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.4%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e83\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.215\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNephropathy (Kidney)\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e23\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.6%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e74\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eTreatment\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTablets\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e498\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e78.5%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e678\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e75.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.124\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155.55pt;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-left: 1pt solid windowtext;border-image: initial;border-top: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eInsulin\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e107\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e16.9%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e185\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e20.5%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.074\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003eOther Chronic diseases\u003c/em\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNone\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e113\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e18%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e108\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e12%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 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0);\"\u003e34%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e280\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp 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0);\"\u003e0.230\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTwo\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp 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0);\"\u003e30%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e261\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp 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0);\"\u003e0.760\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eThree+\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp 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0);\"\u003e19%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e253\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp 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0);\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eChronic lung disease\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp 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0);\"\u003e4.7%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e77\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp 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0);\"\u003e0.004\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAsthma\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp 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0);\"\u003e11.4%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e134\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14.9%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.048\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eArthritis\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e204\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e32.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e382\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e42.4%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eOsteoporosis\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e34\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.4%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e62\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6.9%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.229\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eCancer\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e46\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.3%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e84\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9.3%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.154\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAny emotional, nervous or psychiatric problems\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e63\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9.9%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e142\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e15.7%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAlcohol or substance abuse\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e14\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e37\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.1%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.042\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eStomach ulcers\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e47\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.4%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e10\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.1%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eVaricose Ulcers\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e24\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.8%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e53\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.9%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.065\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eHigh blood pressure or hypertension\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e390\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e61.5%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e602\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e66.7%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.004\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:155.55pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eAngina\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34.4pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e72\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:50.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e11.4%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44.55pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e143\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:58.95pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e15.9%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:49.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.048\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"line-height: 115%;\"\u003eTable 2. Health care utilisation in the last 12 months by older people with diabetes\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cdiv align=\"center\" style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\n \u003ctable style=\"width:462.1pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:168.45pt;border:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:112.6pt;border:solid windowtext 1.0pt;border-left:none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eBefore Matching\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:95.25pt;border:solid windowtext 1.0pt;border-left:none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eAfter Matching\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: 1pt solid windowtext;border-right: 1pt solid windowtext;border-bottom: 1pt solid windowtext;border-image: initial;border-left: none;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:168.45pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eROI (TILDA)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eNI (NICOLA)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eROI (TILDA)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48.65pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eNI (NICOLA)\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:168.45pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:30.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eNo. of people with diabetes\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:56.7pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:30.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e634\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.9pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:30.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e902\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 30.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:46.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:30.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e420\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:30.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e486\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 30.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:168.45pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eGP visits per year (mean including non-users)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:56.7pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.7\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.9pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.6\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.668\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:46.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.6\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.0\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.108\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:168.45pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;GP visits: None\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e7.9%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.004\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.5%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48.65pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9.3%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.006\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:168.45pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eOutpatient visits per year (mean including non-users)\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:56.7pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:55.9pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.6\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026lt;0.001\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:46.6pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.1\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:48.65pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.2\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.079\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:168.45pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Outpatient Visits: None\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56.7pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e38.9%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e38.2%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.79\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46.6pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e40.0%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48.65pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e42.4%\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.9pt;border-top: none;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0in 5.4pt;height: 15.75pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style=\"font-family: Verdana, Geneva, sans-serif;\"\u003e\u003cspan style=\"font-size: 10px;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.47\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:168.45pt;border:solid windowtext 1.0pt;border-top: none;padding:0in 5.4pt 0in 5.4pt;height:15.75pt;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:.0001pt;margin-left:0in;line-height: 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0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style=\"color: rgb(0, 0, 0); font-size: 10px; font-family: Verdana, Geneva, sans-serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Diabetes, Complications, Health Care Utilisation, Quality and Outcomes Framework","lastPublishedDoi":"10.21203/rs.3.rs-16311/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-16311/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e There are social and economic differences between Northern Ireland (NI) and the Republic of Ireland (ROI). There are also differences in the health care systems in the two jurisdictions. The aims of this study are to compare health (prevalence of diabetes and related complications) and health care utilisation (general practitioner, outpatient or accident and emergency utilisation) among older people with diabetes in the NI and ROI. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Large scale comparable surveys of people over 50 years of age in Northern Ireland (NICOLA, wave 1) and the Republic of Ireland (TILDA, wave 1) are used to compare people with diabetes (type I and type II) in the two jurisdictions. The combined data set comprises 1,536 people with diabetes. A coarsened exact matching approach is used to compare health care utilisation among people with diabetes in NI and ROI with equivalent demographic, lifestyle and illness characteristics (age, gender, education, smoking status and self-related health, number of other chronic diseases and number of diabetic complications).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The overall prevalence of diabetes in the 50 to 84 years old age group is 3.4 percentage points higher in NI (11.1% in NI, 7.7% ROI, p-value \u0026lt; 0.01). The diabetic population in NI appear sicker – with more diabetic complications and more chronic illnesses. Comparing people with diabetes in the two jurisdictions with similar levels of illness we find that there are no statistically significant differences in GP, outpatient or A\u0026amp;E utilisation.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Despite the proximity of NI and ROI there are substantial differences in the prevalence of diabetes and its related complications. Despite differences in the health services in the two jurisdictions the differences in health care utilisation for an equivalent cohort are small.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2020-06-20 03:11:20","doi":"10.21203/rs.3.rs-16311/v2","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accept","date":"2020-09-10T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-08-10T12:00:00+00:00","index":3,"fulltext":"Recommendation: Accept after discretionary revisions\nForm responses:\n---\n\nComments to Author:\n---\nPEER REVIEWER ASSESSMENTS:\n\nOBJECTIVE - Full research articles: is there a clear objective that addresses one or several testable research questions? (Brief or other article types: is there a clear objective?)\nYes - there is a clear objective\n\nDESIGN - Is the current approach (including controls and analysis protocols) appropriate for the objective?\nYes - the approach is appropriate\n\nEXECUTION - Are the experiments and analyses performed with sufficient technical rigor to allow confidence in the results?\nYes - experiments and analyses were performed appropriately\n\nSTATISTICS - Is the use of statistics in the manuscript appropriate?\nYes - appropriate statistical analyses have been used in the study\n\nINTERPRETATION - Is the current interpretation/discussion of the results reasonable and not overstated?\nYes - the author's interpretation is reasonable\n\nOVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently for you to now recommend the work as a technically sound contribution? If not, can further revisions be made to make the work technically sound?\nYes - current version is technically sound\n\nPEER REVIEWER COMMENTS:\n\nGENERAL COMMENTS: Both reviewers 1 and 3 provided exceptionally detailed critiques of the original submission. Upon reviewing the authors' response to those critiques (as well as those of reviewer 2), it is clear that the authors have undertaken a substantial revision that thoroughly addresses the reviewers' concerns. I have no further comments on this manuscript.\nADDITIONAL REQUESTS/SUGGESTIONS:\nNo. The authors have done an absolutely stellar job in taking what appears to have been a solid initial submission and thoroughly responding to all reviewer critiques.* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons upon publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **No**\n* Declaration of competing interests: **This reviewer has been recruited by a partner organization, Research Square. Reviewers with declared or apparent competing interests are not utilized for these reviews. This reviewer has agreed to publication of their comments online under a Creative Commons Attribution License attributed to Research Square and was paid a small honorarium for completing the review within a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer recommendation.**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default)**\n* Is the study design appropriate to answer the research question (including the use of appropriate controls), and are the conclusions supported by the evidence presented?: **Yes**\n* Are the methods sufficiently described to allow the study to be repeated?: **Yes**\n* Is the use of statistics and treatment of uncertainties appropriate?: **Yes**\n* Is the presentation of the work clear?: **Yes**\n* Are the images in this manuscript (including electrophoretic gels and blots) free from apparent manipulation?: **Yes**\n"},{"type":"reviewerAgreed","content":"","date":"2020-07-27T12:00:00+00:00","index":3,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-07-06T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n\nComments to Author:\n---\nThank you for the revisions you have made to the manuscript. I appreciate the current challenges accessing data for further analysis.* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons upon publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **Yes**\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I recommend additional statistical review**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please publish my name with my report.**\n"},{"type":"editorInvitedReview","content":"","date":"2020-07-06T12:00:00+00:00","index":2,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n\nComments to Author:\n---\nI have no further comments to be made as all my concerns in a previous version of the paper have been properly addressed.* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons upon publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **Yes**\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default)**\n"},{"type":"reviewerAgreed","content":"","date":"2020-06-22T12:00:00+00:00","index":1,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-06-22T12:00:00+00:00","index":2,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2020-06-19T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2020-06-18T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-06-17T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-06-17T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2020-03-09 15:10:38","doi":"10.21203/rs.3.rs-16311/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2020-04-21T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-04-07T12:00:00+00:00","index":2,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n\nComments to Author:\n---\nFirst of all, I would like to thank the editor of the BMC Public Health and the authors of the manuscript entitled \"A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland\" for having given me the opportunity to read this piece of work. The manuscript is very well-structured and with novel contributions to the existing literature. However, I would like to raise a few comments which might be of help for the authors to improve the manuscript.\n\nABSTRACT\n- In the Background subsection, state that GP denotes General Practitioner.\n- Also, in the Background section, how do you define health and healthcare utilization? Only GPs?\n- From the abstract, it seems that you aim to assess whether the introduction of two different initiatives (QOF and the Cycle of Care programme) had any effect on the health and healthcare use of NI and ROI. But then, you didn´t. I would modify the Background section, just mentioning them as two examples of different healthcare policies within Ireland.\n- Which waves are you using from both datasets?\n- Which variables were used as equivalent demographic, lifestyle and illness characteristics?\n- If illness characteristics entered as control variables in the matching, were they also included as outcomes? In Results, you state that \"The diabetic population in NI also appear sicker - with more diabetic complications and more chronic illnesses\". Hence, were they control matching variables, outcomes or both? It is a bit confusing.\n- Did you also consider hospital admission as one of the outcomes?\n- You aim to conclude from your results that the different care policies implemented, such as the QOF, might be driven differences in quality of care. But you are not able to reach such conclusions from your results. I would modify the conclusions; they seem too ambitious. I agree with you about the fact that there are a range of factors that influence the quality of primary care for people with diabetes, but these should be based on your results. And, unless I am missing something, there is no analysis including the introduction of care policies within your analysis. Otherwise, you should have stated something about it before (not only in the Background subsection).\n\n\nINTRODUCTION\n- You start mentioning the diabetes prevalence among people aged 18 and above. Given the data that you used for the analysis, I would recommend adding the prevalence figures for people aged 50 and above.\n- You switch in the first paragraph, from diabetes, in general, to diabetes type II. Diabetes type I and type II affect different \"profiles\" of individuals: the former corresponds to younger populations, whereas the latter affects older people. In fact, the prevalence of T2DM in people aged 65 years old and over is 25% and one in every two people aged 65 years old and above have T2DM.\n- I would remove or move this sentence somewhere else: \"In addition to direct healthcare costs, diabetes significantly impacts on mortality rates, quality of life and labour market productivity\". Analysing these costs is not within the scope of your study and you could get some of this information from the datasets you used.\n- Are there any specific figures, such as the ones given for the UK, for Ireland only?\n- State what DCCT stands for.\n- If someone reading the article, who is not an expert on diabetes, might not be aware of what means having and HbA1c level above 7.5%. Please briefly mention that it is uncontrolled (or poorly controlled) glucose level.\n- I would think about deleting the part related to glucose control actually or giving it less relevance. The introduction seems a bit unstructured to me. Think about the story that you want to tell, frame it within the figures and the existing literature and what is the contribution of your work. When, in line 60, you talk about the appropriate management of healthcare professionals, I would continue with the following paragraph about GPs instead of glucose control.\n- Since blood sugar is one of the biomarkers enclosed within the QOF, I would move the glucose-related part to line 77 but shortening it. Highlight its relevance within diabetes.\n- Is there any evidence to support this statement: \"The mixed nature of GP care in ROI means that GPs who work longer hours can earn more revenue from private patients which may 80 incentivize them to provide easier access through, for example, extended working hours\"?\n- As you have given some information on the QOF, could you please briefly explain what as well is the aim of the Cycle of Care programme?\n- Line 90: state what WTE stands for instead of in line 92.\n- I definitely suggest rewriting or reorganize the Introduction part. It is too long right now, given the word limit and that some information can be omitted. For example, I would delete the information from line 51 to 68, as the contents related to GP provision, costs and coverage are much more relevant given the purpose of your analysis. Moreover, I would extend a little bit more on the objective of your study. It is too short right now.\n\nMETHODS\n- State what TILDA and NICOLA stand for\n- I would delete the sentence about the health assessment.\n- I would move lines 125-128 to the Introduction.\n- What is the sample size used in your analysis from each dataset?\n- I would suggest to use the closest waves in terms of year from both datasets instead of one from 2011 and another from 2014-2016. As the latter is the only available wave of NICOLA data, I would suggest to use the third wave from TILDA.\n- I would include different subsections within Methods: Data, Statistical approach, etc.\n- Line 145: what do the authors mean by \"the treatment is the healthcare system in which individuals receive care for their condition\"? Do you mean NI and ROI?\n- I recommend performing subgroups analysis: by gender and age (50 - 65; 65+), at least\n\nRESULTS\n- State in Methods that, since in the NICOLA data there was no individual with diabetes aged 85 years or above, you limited the age up to 84 years old.\n- I would shorten the text from lines 164 to 172 as these are only descriptive results.\n- I thought you had limited the sample to 84 years old at maximum. But from Figure 1, I assumed you didn´t. I suggest you do so, as this can influence your results (the oldest old people might be in worse health status and use more healthcare resources).\n- Could you add some other healthcare and non-healthcare use measure? For example, hospital admission and number of times during the previous twelve months (instead of number of nights only); having been admitted to a nursing home or using home care help (professional and non-professional).\n- And any health measure as outcome? Or quality of life?\n- I would encourage the authors to elaborate more on the matching results. How the coefficients change and differ between datasets, as these constitute the main results of the study (they are not descriptive/raw results but adjust for the observables).\n\nDISCUSSION\n- In general, discussion should be revised and rewritten. The authors dedicate two long paragraphs for describing the descriptive results and only one brief paragraph to describe (not discuss) the results from the matching analysis, which should be the main focus of the paper. There is almost no comparison with the existing literature, which should be included.\n- Policy implications derived from the results should be included. More precisely, you could elaborate much more on any potential benefit from QOF and Cycle of Care programe, which could be related to your findings, but not due to these two policies, as you are not assessing the effect of their introduction on the outcomes used.\n- Limitations should be extended: age limit given the absence of diabetes cases within NICOLA for people older than 85 years old; limited healthcare resources; limited timespan (only one wave from both datasets).\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I recommend additional statistical review**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"editorInvitedReview","content":"","date":"2020-04-03T12:00:00+00:00","index":3,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n\nComments to Author:\n---\nDear Authors,\n\nAfter reviewing your manuscript, I have a few questions and comments about the overall objective of your study and the methods used. As it is stated in the manuscript, the aims of the study was to \"compare health and healthcare utilization among people with diabetes in the NI and ROI\". However, I do not believe the methods adequately achieve this purpose. Please see my comments below:\n1. The specific years that the data was collected for each survey used is missing. This could be helpful in understanding the influence of the performance incentives mentioned in the text.\n2. The surveys used are fundamentally different and it is unclear how this was accounting for during matching.\n3. Healthcare systems are very complex and based on my understanding comparing NI and ROI would be similar to comparing the healthcare systems of the US and Canada. Therefore, determining utilization patterns and the underlining reasons for any differences that are observed or lack thereof cannot be adequately explained using the proposed methods. I would suggest focusing your paper on diabetes outcomes and compare those outcomes by health system/location. I think this would be a more compelling paper than focusing on utilization as the outcome.\n4. Moreover, matching participants by health system as the \"treatment\" is not very informative, especially for this age group. As you have mentioned in your manuscript there are several social factors that may contribute to utilization. Also, it is unclear what variable was used to match the \"control\" for the analysis (i.e., number of complications, type of diabetes, number of chronic illnesses, etc.). Clarification is needed.\n5. There is no mention of accounting for geriatric syndromes as they may related to health outcomes and utilization in this population. The American Diabetes Association has outlined recommendations for management of diabetes in older adults that include considerations for geriatric syndromes. If the data does not include variables related to these syndromes, this should be mentioned as a study limitation.\n6. Quality of care is mentioned in the discussion, when it was not the objective of the study or defined as part of healthcare utliization. Clarification is needed.\n\nI hope these comments are helpful.* Are the methods appropriate and well described?: **No**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"editorInvitedReview","content":"","date":"2020-04-03T12:00:00+00:00","index":4,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n\nComments to Author:\n---\nReview: A comparison, for older people with diabetes, of health and health care utilisation in two different health systems on the island of Ireland\n\n- This manuscript was well written, clear and succinct. The title and abstract give an accurate summary of the aim and focus of the study and the major findings. The study design was appropriate to answer the objective of the study. The results was clear with good discussion and identification of possible limitations. I would recommend for publication of this manuscript with some minor suggestions for improvement as highlighted in my comments below.\n\n\nAbstract:\nTypo error in the abstract first sentence:\n\"The overall prevalence in the 50 to 84 years old age group is 3.4 percentage points higher in 35 NI (11.1% in NI, 7.7% ROI, p-value \u003c 0.01).\"\nSuggest to add \" The overall prevalence of diabetes in the …..\"\n\nIntroduction:\n- In the last paragraph, before stating the objective of the study, suggest to include one or two sentences to give clearer justification of the contribution and implication of findings of this study towards the practice of care delivery of diabetes.\n\nResults:\n- Table 1: good to include number of patients in addition to percentages.\n- Table 2: Label what is observations. Is it the number of patients analysed?\n\n\n\n\n\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"reviewerAgreed","content":"","date":"2020-03-30T12:00:00+00:00","index":3,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-03-30T12:00:00+00:00","index":4,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-03-30T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n\nComments to Author:\n---\nThis is an interesting descriptive paper that raises questions about use of services among people with diabetes in two health systems on one island. In comparing the two systems, the paper tends to gloss over the differences in eligibility and access to services among people with diabetes in ROI depending on medical card/private insurance status. The differences within the Irish system, and how these sub-groups compare to patients in NI, could be more carefully outlined.\n\nAbstract\n- The introduction compares QOF and cycle of care however the latter wasn't introduced during the study period , so its not clear what the opening argument is for this analysis. Also, the study is not about quality of care but use of services.\n- The conclusion is largely about quality of care but that isn't the focus of the analysis. The conclusion in the main manuscript is more closely aligned with the study aims.\n\nIntroduction\n- In addition to the description of QOF, include a statement about the impact of QOF on quality of diabetes care and patient outcomes.\n- L84-85 states that diabetes care in Ireland is unstructured based on a study among training practices in one region. How many practices were included in this study? There are 10+ diabetes initiatives in Ireland providing different levels of structured care. This sentence should be explained further.\n- The cycle of care is introduced in this section, however this doesn't align with the period analysed in the study. This would be better kept to the discussion.\n- Line 98-106 outlines the costs associated with health service use in Ireland. The role of out-patient services in the routine management of diabetes should be outlined here also. I'm not sure the cost of inpatient care would be a deterrent and therefore encourage more primary care management as these two services are likely dealing with different levels of severity. For some patients, out-patient services are more likely to be used for routine management of diabetes, this is what should be compared to primary care.\n- The introduction describes a number of factors that could influence health service use in the two jurisdictions. Some of these differences are subtle and may be difficult to follow for those unfamiliar with the two systems. The intro would benefit from a summary paragraph that synthesizes what is already know and what is unknown i.e. the rationale for this study.\n- There are more recent estimates of health service use and costs associated with diabetes in Ireland than those cited in the introduction (see O'Neill et al 2018 Health service utilization and related costs attributable to diabetes. Diabet. Med. 35, 1727- 1734).\n\nMethods\n- Line 125-128 would be more appropriate in the introduction. Are there any data from ROI or NI instead of Scotland register?\n- The methods section only describes the diabetes variable in the dataset. This section should include a brief description on how health service use was assessed in both surveys, what services were considered and use over what time period.\n- What chronic illnesses were considered in the count? Is this based on a multimorbidity index?\n- What percentage of participants were missing data on matching variables?\n\n\nResults\n- It would be helpful if the results section started with an outline of the numbers in each sample and then the combined dataset (as reported in the abstract). Table 1 refers to 8469 in ROI and 8212 in NI- what percentage of total study sample is this, how many removed by omitting those with missing data on matching variables, how many of those included in the matched analysis etc. A flow chart could illustrate the selection of each sample and combined dataset.\n- Comparison of prevalence rates with previous literature should be moved to the discussion (Line 164, 167-168, line 170-171).\n- Use of census data should be described in the methods section.\n- Line 176-180, discussing potential reasons for higher prevalence in NI should be moved to discussion.\n- Similarly, statements discussing profile of participants should be moved to discussion\n- Line 190, Categorisation of chronic disease (3+) needs to be described in the methods section first.\n- Provide n in Table 1 as well as percentage\n- Table 2 reports the mean health service utilisation in the two jurisdictions. Are these means based on those who indicate they used the service or the total sample? Would you consider including the percentage reporting usage of each service as well as the average use, similar to reporting of GP usage?\n- Clarify in title and column headings that the results only apply to people with diabetes.\nDiscussion\n- In the opening sentence, clarify what you mean by representative- is it that the matched samples are representative of the diabetes population in each country, or the analysis is based on two samples of people with diabetes taken from representative cohort studies on the island of Ireland.\n- In terms of the differences in prevalence and factors contributing, are there any studies that look at differences in lifestyle between NI and ROI that could support your proposal that it is due to broader societal factors in the opening paragraph?\n- Could the higher rates of self-reported diagnosed complications be due to differences in routine management? (e.g. QOF tracking and therefore more screening and diagnosis, in Ireland a national retinopathy screening programme was only introduced in the last few years).\n- The discussion (line 227) refers to the greater use of hospital services in Northern Ireland. This is in terms of average number of visits. It would be interesting to see what percentage of patients are using the various hospital services.\n- What are the different data sources used in reference 52 (line 233).\n- The discussion suggests 'a more primary care focused service in ROI, with more frequent GP visits and less frequent secondary care visits'. This assumes all people with diabetes in Ireland have the same access to GP but that isn't the case. Medical card status is one of the main predictors of GP visits in Ireland. How is this difference within the diabetes group in Ireland taken into account in the analysis and interpretation?\n- Line 237 states that 'this finding highlights that there are multiple aspects to quality primary care.' It is not clear what finding the authors are referring to. This analysis doesn't examine waiting times, consultation length or continuity of care so assertions about quality of care are not based on the results of this study. Conclusions about quality of care should be revised or supported by reference to supporting evidence.\n- Line 244, clarify that the cycle of care is only for people with Type 2 diabetes with a medical card. In this paragraph, the authors also refer to a decline in the availability of GPs in ROI -is this based on falling numbers of GPs or more demand on GP time? This argument should be supported by a reference to evidence of this decline/increasing demand.\n- Limitations - could the authors indicate how big a problem recall bias is, when it comes to reporting health service use? What % of people with diabetes are missed by relying solely on self-reported doctor diagnosis and not incorporating data on medications?\n- The study considers Type 1 and Type 2 diabetes together but these patient groups typically have different health service use patterns. How could this influence your results?\n\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **No**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I recommend additional statistical review**\n* Quality of written English: **Acceptable**\n* Declaration of competing interests: **I declare that I have no competing interests**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"reviewerAgreed","content":"","date":"2020-03-27T12:00:00+00:00","index":2,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2020-03-12T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-03-12T12:00:00+00:00","index":1,"fulltext":""},{"type":"submitted","content":"","date":"2020-02-20T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2020-02-20T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-02-19T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-02-19T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3ef758b9-ffb5-4a42-8f60-f3be0d33ff40","owner":[],"postedDate":"June 20th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":67282,"name":"Health Policy"},{"id":67283,"name":"Infectious Diseases"},{"id":67284,"name":"Health Economics \u0026 Outcomes Research"}],"tags":[],"updatedAt":"2020-09-27T15:03:02+00:00","versionOfRecord":{"articleIdentity":"rs-16311","link":"https://doi.org/10.1186/s12889-020-09529-0","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2020-09-24 12:00:00","publishedOnDateReadable":"September 24th, 2020"},"versionCreatedAt":"2020-06-20 03:11:20","video":"","vorDoi":"10.1186/s12889-020-09529-0","vorDoiUrl":"https://doi.org/10.1186/s12889-020-09529-0","workflowStages":[]},"version":"v2","identity":"rs-16311","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-16311","identity":"rs-16311","version":["v2"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}