[Hospitalizations and amputations for diabetes mellitus-trends and small-area variation in Germany]. / Krankenhausfälle und Amputationen bei Diabetes mellitus Zeitreihen und Unterschiede auf kleinräumiger Ebene in Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
; 61(11): 1462-1471, 2018 Nov.
Article
em De
| MEDLINE
| ID: mdl-30191270
ABSTRACT
BACKGROUND:
Hospitalizations and lower limb amputations related to diabetes mellitus (DM) are considered to be potentially avoidable. Appropriate outpatient care of diabetes prevents complications. Rates on potentially avoidable hospitalizations for diabetes are core indicators of the German diabetes surveillance program. International comparisons showed high hospitalization rates in Germany for both indicators.OBJECTIVES:
The objective of this analysis is to describe time trends on hospitalizations and inpatient lower limb amputations (major amputations) for DM. Furthermore, we analyze small area variations. MATERIALS ANDMETHODS:
Based on the German diagnosis related groups (DRGs) dataset we calculated age-standardized rates covering 2005-2015. Calculations rely on the Organisation for Economic Co-operation and Development (OECD) indicator definitions. Time trends are obtained by linear regression modelling. We also stratified into age groups and analyzed 2015 small-area variations using age-adjusted rates.RESULTS:
Crude hospitalization rates were 310 admissions per 100,000 inhabitants in men (amputation rate 15.6) and 216 admissions per 100,000 inhabitants in women (amputation rate 7.1) in 2015. Age-adjusted hospitalizations and amputations rates in women decreased over time (10.3 and 1.2 cases per 100,000 inhabitants and year, respectively). In men, the amputation rate decreased significantly (1.5 cases per 100,000 inhabitants and year). We found higher rates for men than for women in almost all age categories. In eastern Germany and parts of Bavaria and North Rhine-Westphalia rates are particularly high.CONCLUSIONS:
A decrease in hospitalization rates may indicate improvements in ambulatory diabetes care over time. Future studies should consider age-specific differences and small-area variations.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações do Diabetes
/
Diabetes Mellitus
/
Amputação Cirúrgica
/
Hospitalização
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
De
Revista:
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
Ano de publicação:
2018
Tipo de documento:
Article