Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain.
Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; CIBER de Enfermedades Raras (CIBERER), Oviedo, Spain.
Endocrinol Diabetes Nutr (Engl Ed). 2023 Oct;70(8):526-531. doi: 10.1016/j.endien.2023.10.002. Epub 2023 Oct 18.
The quality of diabetes care varies from region to region. The objective of this study is to analyze the characteristics of care in different hospitals in Spain through a specific survey assessing different aspects of care for both children and adults.
Cross-sectional observational voluntary survey study, sent to the heads of the Endocrinology and Pediatric Endocrinology Departments or Units in public hospitals with more than 150 beds, during the first semester of 2021. A total of 105 responses were obtained, 55.5% of the 189 requested, which corresponded to a population served of 31,782,409 people, representing almost 80% of the total population served.
Patients with diabetes under 15 years of age are cared for by Pediatric Departments, but only 58% of them have a specific Diabetes Education Unit for children, and in 72% of the cases, there is one single nurse dedicated to these tasks, and not always full-time. Those over 15 years of age are attended by specialists in Endocrinology and Nutrition in 94.3 % of hospitals. There are Therapeutic Education Units in Diabetes in practically all hospitals (94.3%). However, Diabetes Day Hospitals exist in only 32 centres and cover 40.3% of the population, since in 22 provinces there are none. Virtual and telematic consultations, as well as retinography, are available in more than 70% of cases, but access to a Diabetic Foot Unit only in 54% of centres. Monographic technological consultations on diabetes have become widespread, but access to mental health specialists with diabetes training remains limited (24% of centres), and interdisciplinary (32%) or interlevel (12%) committees are very scarce.
Diabetes care in Spain shows great variability from one region to another, and some deficiencies have been detected that affect a large part of the population, such as access to Diabetic Foot Units, as well as mental health specialists with specific training. The presence of multidisciplinary and mixed committees between levels of care remains scarce.
糖尿病的护理质量因地区而异。本研究的目的是通过专门的调查评估儿童和成人护理的不同方面，分析西班牙不同医院的护理特点。
这是一项横断面观察性自愿调查研究，于 2021 年上半年发送给拥有 150 张以上床位的公立医院内分泌科和儿科内分泌科的负责人。共收到 105 份回复，占要求的 189 份的 55.5%，这对应于 31782409 人的服务人群，占总服务人口的近 80%。
15 岁以下的糖尿病患者由儿科部门护理，但只有 58%的患者有专门的儿童糖尿病教育单位，在 72%的情况下，只有一名护士专门负责这些任务，而且并非总是全职。超过 15 岁的患者由内分泌和营养专家在 94.3%的医院治疗。几乎所有医院都有糖尿病治疗教育单位（94.3%）。然而，只有 32 个中心设有糖尿病日间医院，覆盖了 40.3%的人口，因为在 22 个省份中没有这样的医院。超过 70%的病例都可以进行虚拟和远程医疗咨询以及视网膜摄影，但只有 54%的中心可以获得糖尿病足单位的服务。糖尿病专题技术咨询已经很普遍，但获得有糖尿病培训的心理健康专家的机会仍然有限（24%的中心），跨学科（32%）或跨级别（12%）委员会非常稀缺。
西班牙的糖尿病护理在不同地区存在很大差异，一些缺陷已经被发现，这些缺陷影响了很大一部分人群，例如获得糖尿病足单位的机会，以及有特定培训的心理健康专家。多学科和不同级别之间的混合委员会的存在仍然很少。
