Costes sanitarios de la población con diabetes mellitus tipo 2 en el País Vasco (España) / Healthcare costs of people with type 2 diabetes mellitus in the Basque Country (Spain)

Objetivos: El propósito del estudio fue estimar los costes directos de la atención sanitaria prestada a pacientes con diabetes mellitus tipo 2 (DMT2) en el País Vasco y compararlos con aquellos de la población general con enfermedades crónicas. Material y métodos: Para este estudio transversal, calculamos los costes directos de la atención sanitaria para personas mayores de 35 años con diagnóstico de DMT2 residentes en el País Vasco (n = 126.894) por edad, sexo e índice de privación, y los comparamos con los costes de la población con diagnóstico de una enfermedad crónica distinta a la DMT2 (n = 1.347.043). Resultados: Los costes sanitarios anuales de una persona con DMT2 ascendieron a 3.432 €. Los costes se incrementaron progresivamente con la edad, hasta 4.313 € para personas entre 80 y 84 años. El gasto en hombres fue 161 € mayor que en mujeres (p < 0,001). En las áreas más socioeconómicamente desfavorecidas, el coste por paciente fue 468 € (14,9%) mayor que en el segmento más favorecido (p < 0,001). Además, los costes fueron un 68,5% mayores (p < 0,001) para personas con DMT2 que para otros pacientes con enfermedades crónicas. Los costes directos anuales totales ascendieron a 435,5 millones de euros, lo que constituye un 12,78% del gasto total en sanidad de la región. Conclusiones: En el País Vasco, el coste directo medio de la atención sanitaria a personas con DMT2 es de 3.432€. Este coste es mayor en hombres, en las zonas más desfavorecidas, en grupos de edad más avanzada y crece según el número de comorbilidades (AU)

Objective: The aim of the study was to estimate the direct costs of healthcare provided to patients with type 2 diabetes mellitus (T2DM) in the Basque Country and to compare them with those of the population with chronic diseases. Material and methods: A retrospective, cross-sectional, population-based study. Direct healthcare costs for patients aged over 35 years diagnosed with T2DM in the Basque Country (n = 126,894) were calculated, stratified by age, sex and deprivation index, and compared to the costs for the population diagnosed with a chronic disease other than T2DM (n = 1,347,043). Results: The annual average healthcare cost of a person with T2DM was €3,432. Cost gradually increased with age to €4,313 in patients aged 80 to 84 years. Cost in males were €161 higher as compared to costs in females (P < .001). In the most socioeconomically disadvantaged areas, cost per patient was €468 (14.9%) greater than in the most privileged areas (P < .001). Moreover, cost was 68.5% higher (P < .001) for patients with T2DM than for patients with other chronic diseases. Total annual direct costs amounted to €435.5 million, or 12.78% of total public health expenditure in the region. Conclusions: Direct mean healthcare costs in the Basque Country for patients with T2DM were higher in males, in the most underprivileged areas, in patients with comorbidities, and in older age groups, and represented €3,432 per person per year (AU)

Healthcare costs of people with type 2 diabetes mellitus in the Basque Country (Spain). / Costes sanitarios de la población con diabetes mellitus tipo 2 en el País Vasco (España).

OBJECTIVE: The aim of the study was to estimate the direct costs of healthcare provided to patients with type 2 diabetes mellitus (T2DM) in the Basque Country and to compare them with those of the population with chronic diseases. MATERIAL AND METHODS: A retrospective, cross-sectional, population-based study. Direct healthcare costs for patients aged over 35 years diagnosed with T2DM in the Basque Country (n=126,894) were calculated, stratified by age, sex and deprivation index, and compared to the costs for the population diagnosed with a chronic disease other than T2DM (n=1,347,043). RESULTS: The annual average healthcare cost of a person with T2DM was €3,432. Cost gradually increased with age to €4,313 in patients aged 80 to 84 years. Cost in males were €161 higher as compared to costs in females (P<.001). In the most socioeconomically disadvantaged areas, cost per patient was €468 (14.9%) greater than in the most privileged areas (P<.001). Moreover, cost was 68.5% higher (P<.001) for patients with T2DM than for patients with other chronic diseases. Total annual direct costs amounted to €435.5 million, or 12.78% of total public health expenditure in the region. CONCLUSIONS: Direct mean healthcare costs in the Basque Country for patients with T2DM were higher in males, in the most underprivileged areas, in patients with comorbidities, and in older age groups, and represented €3,432 per person per year.

Prevalence and quality of care indicators of type 2 diabetes in the population of the Basque Country (Spain) / Prevalencia e indicadores de calidad de la atención de la diabetes mellitus tipo 2 en la población del País Vasco (España)

OBJECTIVE: The global prevalence of diabetes mellitus has reached epidemic proportions, and consequently the prevention and management of the disease is now a major public health challenge. This study aims to determine the prevalence of type 2 diabetes mellitus (T2DM) in the Basque Country, and identify new cases and the management of the disease based on data sourced from administrative databases. METHODS: Records of all citizens living in the Basque Country aged ≥35 were reviewed and an algorithm was established to detect the presence of T2DM from registered diagnoses and prescriptions. Information from a four-year period was extracted detailing the demographic variables, requirements recommended by clinical practice guidelines, the level of management of the disease in accordance with local guidelines and the presence of ischemic heart disease. RESULTS: In 2011, there were 134,421 diagnosed cases of T2DM, representing a known prevalence of 9.12%. There were 8,896 new cases. The three main control criteria, glycosylated haemoglobin (HbA1c), LDL-cholesterol (LDLc) and blood pressure (BP), were met in 23.2% of people diagnosed with ischemic heart disease diagnosis and in 24.5% of people without a diagnosis of ischemic heart disease. CONCLUSIONS: The prevalence observed in the Basque Country is lower than that observed in Spain, and the achievement of targets for HbA1c, BP, and LDLc was slightly better, except the BP values, which were similar. The data recorded in this study could lead to the development of strategies to improve clinical care for patients with type 2 diabetes

OBJETIVOS: La prevalencia mundial de la diabetes mellitus tipo 2 (DM2) ha adquirido niveles de epidemia y su prevención y control se ha convertido en uno de los retos más importantes de salud pública. Este estudio tiene como finalidad determinar su prevalencia, nuevos casos y control en el País Vaco, a partir de bases de datos administrativas. MÉTODOS: Se analizaron todos los registros de los ciudadanos del País Vasco con edad ≥35 años y se estableció un algoritmo para detectar la presencia de DM2 a partir de diagnósticos y prescripciones registrados. Se extrajo información relativa a un período de 4 años de variables demográficas, recomendaciones de las guías de práctica clínica, grado de control de la enfermedad de acuerdo con las guías locales y presencia de cardiopatía isquémica. RESULTADOS: En 2011, 134.421 personas tenían DM2, es decir, una prevalencia conocida del 9,12%. Hubo 8.896 casos nuevos. Los criterios principales de control (hemoglobina glicosilada (HbA1c), colesterol LDL (LDLc) y presión arterial (PA)) se alcanzaron en el 23,15% de las personas con diagnóstico de cardiopatía isquémica y en el 24,54% de personas sin diagnóstico de cardiopatía isquémica. CONCLUSIONES: La prevalencia observada en el País Vasco es más baja que la observada en España, y el alcance de los objetivos para HbA1c, PA y LDLc fue ligeramente mejor excepto en la PA que fueron similares. Los datos registrados en este estudio podrían dar lugar al desarrollo de estrategias para mejorar la atención clínica de los pacientes con DM2

The prevalence of diabetes-related complications and multimorbidity in the population with type 2 diabetes mellitus in the Basque Country.

BACKGROUND: Type 2 diabetes mellitus is associated with a diverse range of pathologies. The aim of the study was to determine the incidence of diabetes-related complications, the prevalence of coexistent chronic conditions and to report multimorbidity in people with type 2 diabetes living in the Basque Country. METHODS: Administrative databases, in four cross sections (annually from 2007 to 2011) were consulted to analyse 149,015 individual records from patients aged ≥ 35 years with type 2 diabetes mellitus. The data observed were: age, sex, diabetes-related complications (annual rates of acute myocardial infarction, major amputations and avoidable hospitalisations), diabetes-related pathologies (prevalence of ischaemic heart disease, renal failure, stroke, heart failure, peripheral neuropathy, foot ulcers and diabetic retinopathy) and other unrelated pathologies (44 diseases). RESULTS: The annual incidence for each condition progressively decreased during the four-year period: acute myocardial infarction (0.47 to 0.40%), major amputations (0.10 to 0.08%), and avoidable hospitalisations (5.85 to 5.5%). The prevalence for diabetes-related chronic pathologies was: ischaemic heart disease (11.5%), renal failure (8.4%), stroke (7.0%), heart failure (4.3%), peripheral neuropathy (1.3%), foot ulcers (2.0%) and diabetic retinopathy (7.2%). The prevalence of multimorbidity was 90.4%. The highest prevalence for other chronic conditions was 73.7% for hypertension, 13.8% for dyspepsia and 12.7% for anxiety. CONCLUSIONS: In the type 2 diabetes mellitus population living in the Basque Country, incidence rates of diabetes complications are not as high as in other places. However, they present a high prevalence of diabetes related and unrelated diseases. Multimorbidity is very common in this group, and is a factor to be taken into account to ensure correct clinical management.

Geographical analysis of the sporadic Creutzfeldt-Jakob disease distribution in the autonomous community of the Basque Country for the period 1995-2008.

BACKGROUND: The Basque Country, in Spain, shows one of the highest sporadic Creutzfeldt-Jakob disease (sCJD) incidence rates in Europe. The purpose is to analyse a possible focus of unidentified external or environmental factors which could trigger the high incidence rates of sCJD in the Basque Country. METHODS: We estimated the relative risk and the posterior relative risk distribution of sCJD cases for each town of the Basque Country and for the period 1995-2008. RESULTS: 58 sCJD cases (44 definite and 14 probable) were selected for the geographic cluster analysis. In a first approach, referring to the relative risk, several municipalities in the Autonomous Community of the Basque Country showed more sCJD cases than expected. However, the posterior relative risk distribution showed no excess risk areas. CONCLUSIONS: RESULTS from this survey indicate that a possible common source of development of the disease does not seem to be the reason of the high sCJD incidence.