Trends on Diabetes Mellitus's healthcare management in Spain 2007-2015
Por:
Reyes García R, Luis Bernal Sobrino J, Fernandez Pérez C, Morillas Ariño C, Azriel Mira S, Javier Elola Somoza F, Breton Lesmes I and Botella Romero F
Publicada:
1 oct 2019
Ahead of Print:
22 ago 2019
Resumen:
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.
Filiaciones:
Reyes García R:
Unidad de endocrinología y nutrición. Hospital Universitario Torrecárdenas. Almería
Sociedad Española de Endocrinología y Nutrición (SEEN)
Luis Bernal Sobrino J:
Fundación Instituto para la Mejora de la Asistencia Sanitaria. Hospital 12 de Octubre. Madrid
Fernandez Pérez C:
Fundación Instituto para la Mejora de la Asistencia Sanitaria. Hospital 12 de Octubre. Madrid
:
Sociedad Española de Endocrinología y Nutrición (SEEN)
Sección de Endocrinología y nutrición. Hospital Universitario Dr Peset. Valencia
Azriel Mira S:
Sociedad Española de Endocrinología y Nutrición (SEEN)
Servicio de Endocrinología y Nutrición. Hospital Universitario Infanta Sofia. Madrid
Javier Elola Somoza F:
Fundación Instituto para la Mejora de la Asistencia Sanitaria. Hospital 12 de Octubre. Madrid
Breton Lesmes I:
Sociedad Española de Endocrinología y Nutrición (SEEN)
Servicio de Endocrinologia y Nutrición. Hospital General Universitario Gregorio Marañón. Madrid
Botella Romero F:
Sociedad Española de Endocrinología y Nutrición (SEEN)
Gerencia de Atención Integrada de Albacete. Albacete
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