Andrade L F, Rapp T, Sevilla-Dedieu C
MGEN Foundation for Public Health, 3 square Max Hymans, 75747, Paris Cedex 15, France.
LIRAES (EA 4470), University of Paris Descartes, 45 rue des Saints-Pères, 75270, Paris Cedex 06, France.
Int J Health Econ Manag. 2018 Jun;18(2):153-167. doi: 10.1007/s10754-017-9230-z.
Diabetes may lead to severe complications. For this reason, disease prevention and improvement of medical follow-up represent major public health issues. The aim of this study was to measure the impact of adherence to French follow-up guidelines on hospitalization of people with diabetes. We used insurance claims data from the years 2010 to 2013 collected for 52,027 people aged over 18, affiliated to a French social security provider and treated for diabetes. We estimated panel data models to explore the association between adherence to guidelines and different measures of hospitalization, controlling for socioeconomic characteristics, diabetes treatment and density of medical supply. The results show that adherence to four guidelines was associated with a significant decrease in hospital admissions, up to approximatively 30% for patients monitored for a complete lipid profile or microalbuminuria during the year. In addition, our analyses confirmed the strong protective effect of income and a significant positive correlation with good supply of hospital care. In conclusion, good adherence to French diabetes guidelines seems to be in line with the prevention of health events, notably complications, that could necessitate hospitalization.
糖尿病可能导致严重并发症。因此,疾病预防和改善医疗随访是重大的公共卫生问题。本研究的目的是衡量遵守法国随访指南对糖尿病患者住院情况的影响。我们使用了2010年至2013年期间为52027名18岁以上、隶属于法国社会保障机构并接受糖尿病治疗的患者收集的保险理赔数据。我们估计了面板数据模型,以探讨遵守指南与不同住院指标之间的关联,同时控制社会经济特征、糖尿病治疗和医疗供应密度。结果表明,遵守四项指南与住院次数显著减少相关,对于当年接受完整血脂谱或微量白蛋白尿监测的患者,减少幅度高达约30%。此外,我们的分析证实了收入的强大保护作用以及与良好医院护理供应的显著正相关。总之,良好遵守法国糖尿病指南似乎与预防可能需要住院治疗的健康事件,尤其是并发症相一致。