Institute for Health Services Research and Health Economics, German Diabetes Centre (DDZ), Leibniz Centre for Diabetes Research at Heinrich-Heine-University Düsseldorf, Auf´m Hennekamp 65, 40225, Düsseldorf, Germany.
Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Eur J Epidemiol. 2022 Jun;37(6):587-590. doi: 10.1007/s10654-022-00865-6. Epub 2022 Jun 8.
Most studies reported reduced health care use among people with diabetes during the COVID-19 pandemic. This may be due to restricted medical services or people avoiding health care services because they fear being infected with COVID-19 in health care facilities. The aim of our study was to analyse hospitalisation and mortality in people with and without diabetes in Germany during the COVID-19 pandemic year 2020 compared to 2017-2019. The data were sourced from a German statutory health insurance company covering 3.2 million people. We estimated age-sex standardised rates of mortality, all-cause hospitalisation, hospitalisation due to coronary heart disease (CHD), acute myocardial infarction (AMI), stroke, diabetic foot syndrome (DFS), and major and minor amputations in people with and without diabetes. We predicted rates for 2020 using Poisson regression based on results from 2017-2019 and compared these with the observed rates.In people with diabetes, the hospitalisation rate for major amputation was significantly increased, while all-cause hospitalisation rate and hospitalisation due to CHD, AMI and DFS were significantly decreased compared to the previous period. Moreover, we found a significantly increased mortality and hospitalisation rate for minor amputation in people without diabetes while all-cause hospitalisation and hospitalisation due to CHD and AMI was significantly lower during the COVID-19 pandemic year 2020.We observed changes in health care utilisation and outcomes during the COVID-19 pandemic compared to previous years in people with and without diabetes. Concerning diabetes care, the increase of hospitalisations due to amputation in people with diabetes with a simultaneous reduction in DFS needs special attention.
大多数研究报告称，在 COVID-19 大流行期间，糖尿病患者的医疗保健使用量减少。这可能是由于医疗服务受限，或者人们因为担心在医疗机构感染 COVID-19 而避免使用医疗服务。我们的研究目的是分析 2020 年与 2017-2019 年相比，德国有和没有糖尿病的人在 COVID-19 大流行期间的住院和死亡率。数据来自一家覆盖 320 万人的德国法定健康保险公司。我们估计了有和没有糖尿病的人在年龄和性别标准化死亡率、全因住院率、因冠心病（CHD）、急性心肌梗死（AMI）、中风、糖尿病足综合征（DFS）和主要和次要截肢的住院率。我们使用基于 2017-2019 年结果的泊松回归来预测 2020 年的比率，并将这些比率与观察到的比率进行比较。在有糖尿病的人中，主要截肢的住院率显著增加，而全因住院率以及因 CHD、AMI 和 DFS 的住院率则显著降低。此外，我们发现无糖尿病的人中次要截肢的死亡率和住院率显著增加，而全因住院率以及因 CHD 和 AMI 的住院率在 COVID-19 大流行年 2020 年显著降低。与前几年相比，我们观察到 COVID-19 大流行期间有和没有糖尿病的人医疗保健利用和结果发生了变化。在糖尿病护理方面，糖尿病患者因截肢而住院的人数增加，同时 DFS 减少，这需要特别关注。
