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. 2019 Dec 27;19(1):1002.
doi: 10.1186/s12913-019-4840-4.

The impact of diabetes on multiple avoidable admissions: a cross-sectional study

Joana Seringa  1 , Ana Patrícia Marques  2   3 , Bruno Moita  4   5 , Cátia Gaspar  4 , João Filipe Raposo  6   7 , Rui Santana  2   3
Affiliations

The impact of diabetes on multiple avoidable admissions: a cross-sectional study

Joana Seringa et al. BMC Health Serv Res. .

Abstract

Background: Multiple admissions for ambulatory care sensitive conditions (ACSC) are responsible for an important proportion of health care expenditures. Diabetes is one of the conditions consensually classified as an ACSC being considered a major public health concern. The aim of this study was to analyse the impact of diabetes on the occurrence of multiple admissions for ACSC.

Methods: We analysed inpatient data of all public Portuguese NHS hospitals from 2013 to 2015 on multiple admissions for ACSC among adults aged 18 or older. Multiple ACSC users were identified if they had two or more admissions for any ACSC during the period of analysis. Two logistic regression models were computed. A baseline model where a logistic regression was performed to assess the association between multiple admissions and the presence of diabetes, adjusting for age and sex. A full model to test if diabetes had no constant association with multiple admissions by any ACSC across age groups.

Results: Among 301,334 ACSC admissions, 144,209 (47.9%) were classified as multiple admissions and from those, 59,436 had diabetes diagnosis, which corresponded to 23,692 patients. Patients with diabetes were 1.49 times (p < 0,001) more likely to be admitted multiple times for any ACSC than patients without diabetes. Younger adults with diabetes (18-39 years old) were more likely to become multiple users.

Conclusion: Diabetes increases the risk of multiple admissions for ACSC, especially in younger adults. Diabetes presence is associated with a higher resource utilization, which highlights the need for the implementation of adequate management of chronic diseases policies.

Keywords: Diabetes; Multimorbidity; Multiple admissions for ACSC.

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Conflict of interest statement

Prof. João Filipe Raposo, M.D., Ph.D., exercise coordinating, executive and management functions at Associação Protetora dos Diabéticos de Portugal.

Figures

Fig. 1
Fig. 1
Diagram of distribution of admissions, patients and total costs
See this image and copyright information in PMC

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