Trends on Diabetes Mellitus's healthcare management in Spain 2007-2015

Autor: Reyes García R, Luis Bernal Sobrino J, Fernandez Pérez C, Morillas Ariño C, Azriel Mira S, Javier Elola Somoza F, Breton Lesmes I, Botella Romero F
Rok vydání: 2019
Předmět:
Zdroj: DIABETES RESEARCH AND CLINICAL PRACTICE
r-FISABIO: Repositorio Institucional de Producción Científica
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
r-FISABIO. Repositorio Institucional de Producción Científica
instname
ISSN: 2007-2015
0168-8227
Popis: Aims: To analyze the trends on diabetes mellitus (DM) healthcare management in Spain. Methods: Retrospective observational study between January 1st 2007 and 31th December 2015 with DM as the principal diagnosis. The main clinical outcome measures were all-cause, in-hospital mortality and 30-day readmissions. We also analyze three Prevention Quality Indicators (PQI) for DM. Results: The number of hospitalization episodes decreased significantly as well as the frequentation rate and average length of stay (Incidence Rate Ratio [IRR] = 0.963, p < 0.001; 0.91, p < 0.001 and 0.986, p < 0.001, respectively). Crude in-hospital mortality and readmissions rates and risk-standardized in-hospital mortality rates (RSMR), however, remained stable (IRR = 0.988, p = 0.073; IRR = 1.003, p = 0.334 and IRR = 0.997, p = 0.116, respectively). A relevant variability in RSMR, both at hospital (Median Odds Ratio 1.49) and regional level, was found. High volume hospitals (>= 105 DM discharges at year) showed better outcomes. High variability was also found in PQI indicators al regional level. Conclusion: The present analysis shows an improvement in hospitalizations related to DM in Spain in the period 2007-2015. There was also a decrease in the frequentation rate and in the average length of stay. These findings are probably explained by quality improvements in the healthcare management of the DM at the ambulatory level. However, there were important differences in the management of diabetic inpatients both at the hospital and the regional level. (C) 2019 Elsevier B.V. All rights reserved.
Databáze: OpenAIRE
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