Department of Cardiologic, Vascular, and Thoracic Sciences, and Public Health, University of Padua, Padova, Italy.
School of Specialization in Hygiene, Preventive Medicine and Public Health, University of Padua, Padova, Italy.
Prim Care Diabetes. 2021 Apr;15(2):397-404. doi: 10.1016/j.pcd.2020.12.002. Epub 2020 Dec 25.
To describe the impact of diabetes comorbidities on the health care services use and costs of a cohort of elderly patients with diabetes and high health care needs (HHCN), based on real-world data.
We focused on a cohort of diabetic patients with HHCN belonging to Resource Utilization Bands 4 and 5 according to the Adjusted Clinical Group (ACG) system. Their comorbidities were assessed using the clinical diagnoses that the ACG system assigns to single patients by combining different information flows. Regression models were applied to analyze the associations between comorbidities and health care service use or costs, adjusting for age and sex.
Our analyses showed that all health care service usage measures (e.g. access to emergency care; number of outpatient visits) and the total annual costs and pharmacy costs are associated significantly with comorbidity class. Instead, no differences in hospitalization rates by comorbidity class were revealed.
The association between a larger number of comorbidities and higher total health care service usage and costs was seen mainly for primary care services. This underscores the need to strengthen primary care for today's aging and multimorbid population.
根据真实世界数据，描述糖尿病合并症对具有高医疗需求（HHCN）的老年糖尿病患者队列的医疗服务使用和成本的影响。
我们专注于根据调整后的临床分组（ACG）系统属于资源利用带 4 和 5 的 HHCN 糖尿病患者队列。使用 ACG 系统通过组合不同信息流为单个患者分配的临床诊断来评估其合并症。应用回归模型分析合并症与医疗服务使用或成本之间的关联，调整年龄和性别因素。
我们的分析表明，所有医疗服务使用措施（例如急诊就诊；门诊就诊次数）和总年度费用和药房费用与合并症类别显著相关。然而，合并症类别与住院率之间没有差异。
更多合并症与更高的整体医疗服务使用和成本之间的关联主要见于初级保健服务。这凸显了加强初级保健以满足当今老龄化和多病共存人群的需求的必要性。
