ABSTRACT
Introducción. Este estudio analiza el estado de salud de los pacientes con diabetes mellitus (DM), su calidad de vida relacionada con la salud (CVRS) y la utilización de recursos sanitarios. Material y métodos. Se utilizó la Encuesta Nacional de Salud (2012), identificando a aquellas personas de 15 años o más diagnosticadas de DM. Se realizó un análisis descriptivo de su estado de salud, CVRS y utilización de recursos sanitarios, y se compararon sistemáticamente con pacientes con otras enfermedades crónicas (OEC) y con población sin DM (no DM). Resultados. De los 21.007 sujetos participantes, el 7,4% tenían DM y el 59% OEC (edad media 65,6±14,2 años para DM; 51,3±18,1 años para OEC y 45,7±18,2 años para no DM). En comparación con no DM y OEC, la DM se asoció, de forma estadísticamente significativa, con una mayor frecuencia de hipertensión, hipercolesterolemia, obesidad, infarto de miocardio, hospitalización en el último año y consumo de medicamentos, pero con un menor número de visitas a atención secundaria. La media anual de años de vida ajustados por calidad (AVAC) en DM fue 0,75, significativamente inferior (p<0,05) a la de las personas con OEC (0,89) y a la de la población no DM (0,92). La diferencia con respecto a no DM se mantuvo estadísticamente significativa cuando se ajustó por edad, sexo y número de comorbilidades (p<0,001). Conclusiones. En España, la DM está asociada a una elevada comorbilidad, conlleva una pérdida de AVAC mayor a la del conjunto de personas con OEC y genera una carga significativa sobre el sistema sanitario (AU)
Introduction. This study analyses the health status of patients diagnosed with diabetes mellitus (DM), their health related quality of life (HRQoL) and their use of healthcare resources in Spain. Materials and methods. A descriptive analysis was conducted using the Spanish Health National Survey (ENSE, 2012), gathering data on those patients aged 15 and over diagnosed with DM. Their health status, their HRQoL, and their use of healthcare resources were systematically compared with those of patients diagnosed with other chronic conditions (OCC), as well as a population without DM (non-DM). Results. Out of 21,007 subjects that took part, 7.4% were diagnosed with DM and 59% with OCC conditions (mean age 65.6±14.2 years with DM, 51.3±18.1 years with OCC, and 45.7±18.2 years with non-DM). When compared to non-DM and OCC, DM was statistically significantly associated with higher frequencies of hypertension, hypercholesterolaemia, obesity, myocardial infraction, hospital admissions in the last year, and drug consumption, but with a lower number of visits to secondary healthcare. The mean quality adjusted life years (QALY) of patients with DM was 0.75 per year, significantly lower (P<.05) to that of individuals with OCC (0.89), and those without DM (0.92). The difference vs. non-DM remained statistically significant after adjusting for age, gender, and number of comorbidities (P<.001). Conclusions. In Spain, DM is associated with a high comorbidity, involves a greater loss in HRQoL than those diagnosed with other chronic conditions as a whole, and generates a significant burden on the healthcare system (AU)
Subject(s)
Humans , Adult , Middle Aged , Aged , Diabetes Mellitus/epidemiology , Diabetes Mellitus/prevention & control , Quality of Life , Health Status , Health Resources , Chronic Disease/epidemiology , Health Resources/organization & administration , Spain/epidemiology , Surveys and Questionnaires , Health Surveys/methods , Health Surveys/statistics & numerical data , 28599ABSTRACT
INTRODUCTION: This study analyses the health status of patients diagnosed with diabetes mellitus (DM), their health related quality of life (HRQoL) and their use of healthcare resources in Spain. MATERIALS AND METHODS: A descriptive analysis was conducted using the Spanish Health National Survey (ENSE, 2012), gathering data on those patients aged 15 and over diagnosed with DM. Their health status, their HRQoL, and their use of healthcare resources were systematically compared with those of patients diagnosed with other chronic conditions (OCC), as well as a population without DM (non-DM). RESULTS: Out of 21,007 subjects that took part, 7.4% were diagnosed with DM and 59% with OCC conditions (mean age 65.6±14.2 years with DM, 51.3±18.1 years with OCC, and 45.7±18.2 years with non-DM). When compared to non-DM and OCC, DM was statistically significantly associated with higher frequencies of hypertension, hypercholesterolaemia, obesity, myocardial infraction, hospital admissions in the last year, and drug consumption, but with a lower number of visits to secondary healthcare. The mean quality adjusted life years (QALY) of patients with DM was 0.75 per year, significantly lower (P<.05) to that of individuals with OCC (0.89), and those without DM (0.92). The difference vs. non-DM remained statistically significant after adjusting for age, gender, and number of comorbidities (P<.001). CONCLUSIONS: In Spain, DM is associated with a high comorbidity, involves a greater loss in HRQoL than those diagnosed with other chronic conditions as a whole, and generates a significant burden on the healthcare system.
Subject(s)
Diabetes Mellitus/epidemiology , Health Resources/statistics & numerical data , Health Status , Quality of Life , Adult , Aged , Chronic Disease , Comorbidity , Diabetes Mellitus/physiopathology , Female , Health Surveys , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Quality-Adjusted Life Years , Spain/epidemiologyABSTRACT
The aim of this study was to assess the lifetime economic benefits of assisted reproduction in Spain by calculating the return on this investment. We developed a generational accounting model that simulates the flow of taxes paid by the individual, minus direct government transfers received over the individual's lifetime. The difference between discounted transfers and taxes minus the cost of either IVF or artificial insemination (AI) equals the net fiscal contribution (NFC) of a child conceived through assisted reproduction. We conducted sensitivity analysis to test the robustness of our results under various macroeconomic scenarios. A child conceived through assisted reproduction would contribute 370,482 in net taxes to the Spanish Treasury and would receive 275,972 in transfers over their lifetime. Taking into account that only 75% of assisted reproduction pregnancies are successful, the NFC was estimated at 66,709 for IVF-conceived children and 67,253 for AI-conceived children. The return on investment for each euro invested was 15.98 for IVF and 18.53 for AI. The long-term NFC of a child conceived through assisted reproduction could range from 466,379 to -9,529 (IVF) and from 466,923 to -8,985 (AI). The return on investment would vary between -2.28 and 111.75 (IVF), and -2.48 and 128.66 (AI) for each euro invested. The break-even point at which the financial position would begin to favour the Spanish Treasury ranges between 29 and 41 years of age. Investment in assisted reproductive techniques may lead to positive discounted future fiscal revenue, notwithstanding its beneficial psychological effect for infertile couples in Spain.
