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Álvarez-Dobaño JM, Atienza G, Zamarrón C, Toubes ME, Ferreiro L, Riveiro V, Casal A, Suárez-Antelo J, Rodríguez-Núñez N, Lama-López A, Rábade-Castedo C, Rodríguez-García C, Lourido-Cebreiro T, Ricoy J, Abelleira R, Golpe A, Pais B, González-Barcala FJ, Valdés L. Health outcomes: Towards the accreditation of respiratory medicine departments. Arch Bronconeumol 2021; 57:637-647. [PMID: 35702904 DOI: 10.1016/j.arbr.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/13/2021] [Indexed: 06/15/2023]
Abstract
National health systems must ensure compliance with conditions such as equity, efficiency, quality, and transparency. Since it is the right of society to know the health outcomes of its healthcare system, our aim was to develop a proposal for the accreditation of respiratory medicine departments in terms of care, teaching, and research, measuring health outcomes using quality of care indicators. The management tools proposed in this article should be implemented to improve outcomes and help us achieve our objectives. Promoting accreditation can serve as a stimulus to improve clinical management and enable professionals to take on greater leadership roles and take action to improve outcomes in patient care.
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Affiliation(s)
- José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Gerardo Atienza
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, Spain
| | - Carlos Zamarrón
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - María Elena Toubes
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Lucía Ferreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain.
| | - Vanessa Riveiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Casal
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Juan Suárez-Antelo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Adriana Lama-López
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Tamara Lourido-Cebreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Jorge Ricoy
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Romina Abelleira
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Antonio Golpe
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Beatriz Pais
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, Spain
| | - Francisco Javier González-Barcala
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain; Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
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Álvarez-Dobaño JM, Atienza G, Zamarrón C, Toubes ME, Ferreiro L, Riveiro V, Casal A, Suárez-Antelo J, Rodríguez-Núñez N, Lama-López A, Rábade-Castedo C, Rodríguez-García C, Lourido-Cebreiro T, Ricoy J, Abelleira R, Golpe A, Pais B, González-Barcala FJ, Valdés L. Health Outcomes: Towards the Accreditation of Respiratory Medicine Departments. Arch Bronconeumol 2021; 57:S0300-2896(21)00029-6. [PMID: 33678474 DOI: 10.1016/j.arbres.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/04/2021] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
National health systems must ensure compliance with conditions such as equity, efficiency, quality, and transparency. Since it is the right of society to know the health outcomes of its healthcare system, our aim was to develop a proposal for the accreditation of respiratory medicine departments in terms of care, teaching, and research, measuring health outcomes using quality of care indicators. The management tools proposed in this article should be implemented to improve outcomes and help us achieve our objectives. Promoting accreditation can serve as a stimulus to improve clinical management and enable professionals to take on greater leadership roles and take action to improve outcomes in patient care.
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Affiliation(s)
- José Manuel Álvarez-Dobaño
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Gerardo Atienza
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, España
| | - Carlos Zamarrón
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - María Elena Toubes
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Lucía Ferreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España.
| | - Vanessa Riveiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Ana Casal
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Juan Suárez-Antelo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Nuria Rodríguez-Núñez
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Adriana Lama-López
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Tamara Lourido-Cebreiro
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Jorge Ricoy
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Romina Abelleira
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, España
| | - Antonio Golpe
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Beatriz Pais
- Unidad de Calidad y Seguridad del Paciente, Subdirección de Calidad, Área Sanitaria de Santiago de Compostela y Barbanza, Santiago de Compostela, España
| | - Francisco Javier González-Barcala
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, España
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Elliott MJ, Love S, Donald M, Manns B, Donald T, Premji Z, Hemmelgarn BR, Grinman M, Lang E, Ronksley PE. Outpatient Interventions for Managing Acute Complications of Chronic Diseases: A Scoping Review and Implications for Patients With CKD. Am J Kidney Dis 2020; 76:794-805. [PMID: 32479925 DOI: 10.1053/j.ajkd.2020.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 04/02/2020] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Patients with chronic kidney disease (CKD) have high rates of emergency department (ED) use and hospitalization. Outpatient care may provide an alternative to ED and inpatient care in this population. We aimed to explore the scope of outpatient interventions used to manage acute complications of chronic diseases and highlight opportunities to adapt and test interventions in the CKD population. STUDY DESIGN Scoping review of quantitative and qualitative studies. SETTING & POPULATION Outpatient interventions for adults experiencing acute complications related to 1 of 5 eligible chronic diseases (ie, CKD, chronic respiratory disease, cardiovascular disease, cancer, and diabetes). SELECTION CRITERIA FOR STUDIES MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, grey literature, and conference abstracts were searched to December 2019. DATA EXTRACTION Intervention and study characteristics were extracted using standardized tools. ANALYTICAL APPROACH Quantitative data were summarized descriptively; qualitative data were summarized thematically. Our approach observed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) extension for scoping reviews. RESULTS 77 studies (25 randomized controlled trials, 29 observational, 12 uncontrolled before-after, 5 quasi-experimental, 4 qualitative, and 2 mixed method) describing 57 unique interventions were included. Of identified intervention types (hospital at home [n = 16], observation unit [n = 9], ED-based specialist service [n = 4], ambulatory program [n = 18], and telemonitoring [n = 10]), most were studied in chronic respiratory and cardiovascular disease populations. None targeted the CKD population. Interventions were delivered in the home, ED, hospital, and ambulatory setting by a variety of health care providers. Cost savings were demonstrated for most interventions, although improvements in other outcome domains were not consistently observed. LIMITATIONS Heterogeneity of included studies; lack of data for outpatient interventions for acute complications related to CKD. CONCLUSIONS Several interventions for outpatient management of acute complications of chronic disease were identified. Although none was specific to the CKD population, features could be adapted and tested to address the complex acute-care needs of patients with CKD.
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Affiliation(s)
- Meghan J Elliott
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
| | - Shannan Love
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Maoliosa Donald
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Bryn Manns
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Teagan Donald
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Zahra Premji
- Department of Libraries and Cultural Resources, University of Calgary, Calgary, AB, Canada
| | - Brenda R Hemmelgarn
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Michelle Grinman
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Eddy Lang
- Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada
| | - Paul E Ronksley
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Gonzalez-Barcala FJ, Calvo-Alvarez U, Salgado-Castro FJ, Facal D, Garcia-Sanz MT, Muñoz X, Garcia-Couceiro N, Paz-Neira O, San-Jose E, Valdes-Cuadrado L, Carreira JM. Asthma exacerbations: factors related to longer hospital stay. Acta Clin Belg 2017; 72:379-384. [PMID: 28245723 DOI: 10.1080/17843286.2017.1295524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Hospital admissions account for a significant part of asthma cost, but with significant differences between geographic areas. AIMS The aim of our study is to analyse hospital admissions due to asthma, as well as the factors associated with longer hospital stays. METHODS A review was retrospectively carried out on all admissions of patients over 18 years old due to exacerbation of asthma occurring in our hospital between the years 2000 and 2010. The personal characteristics of each patient, the asthma personal history, characteristics of every exacerbation, as well as the treatment before admission and after hospital discharge were recorded. RESULTS During the study period, there were 2163 hospital admissions in 1316 patients (mean age 62.6 years; mean hospital stay 11.6 days). The admissions mainly occur in winter, in the 56-75-year age group, and in patients with severe asthma. Female sex, higher comorbidity, a greater number of emergencies due to asthma in the previous year, and baseline treatment with theophylline were independently associated to longer hospital stay. CONCLUSIONS The management of asthma in our population seems improvable. There appears to be a need to optimise both the diagnosis and treatment of the disease, and to identify risk factors as important as tobacco habits. As regards exacerbations, the hospital stay and mortality must be significantly reduced.
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Affiliation(s)
- Francisco-Javier Gonzalez-Barcala
- Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Spanish Biomedical Research Networking Centre, CIBERES, Santiago de Compostela, Spain
- Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Uxio Calvo-Alvarez
- Department of Respiratory Medicine, Hospital of El Ferrol, El Ferrol, Spain
| | - Francisco-Javier Salgado-Castro
- Faculty of Biology/CIBUS, Department of Biochemistry and Molecular Biology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - David Facal
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Xavier Muñoz
- Spanish Biomedical Research Networking Centre, CIBERES, Santiago de Compostela, Spain
- Department of Medicine, University Autònoma of Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Hospital Vall d’Hebron, Barcelona, Spain
| | - Nuria Garcia-Couceiro
- Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Olalla Paz-Neira
- Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Esther San-Jose
- Central Laboratory, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Luis Valdes-Cuadrado
- Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Jose-Martin Carreira
- Department of Radiology, University of Santiago de Compostela, Santiago de Compostela, Spain
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Huertas D, Montón C, Marín A, Solanes I, López-Sánchez M, Pomares X, Muñoz-Esquerre M, Dorca J, Santos S. Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study. COPD 2017; 14:304-310. [DOI: 10.1080/15412555.2017.1279598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Daniel Huertas
- Respiratory Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomedica de Bellvitge (IDIBELL), Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Concepción Montón
- Respiratory Department, Hospital de Sabadell, Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
- REDISSEC: Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Madrid, Spain
| | - Alicia Marín
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Respiratory Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Ingrid Solanes
- Respiratory Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Biomedical Research Institute Sant Pau, Barcelona, Spain
| | - Marta López-Sánchez
- Respiratory Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomedica de Bellvitge (IDIBELL), Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Pomares
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Respiratory Department, Hospital de Sabadell, Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
| | - Mariana Muñoz-Esquerre
- Respiratory Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomedica de Bellvitge (IDIBELL), Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Dorca
- Respiratory Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomedica de Bellvitge (IDIBELL), Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Salud Santos
- Respiratory Department, Hospital Universitari de Bellvitge, Institut d'Investigació Biomedica de Bellvitge (IDIBELL), Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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6
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Lourido-Cebreiro T, Rodríguez-García C, Gude F, Valdés L. Is a Respiratory Day Hospital Useful in Patients with Severe Disease? Arch Bronconeumol 2016; 53:400-402. [PMID: 28012575 DOI: 10.1016/j.arbres.2016.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Tamara Lourido-Cebreiro
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España.
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
| | - Francisco Gude
- Unidad de Epidemiología Clínica, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Grupo Epidemiología de Enfermedades Frecuentes, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
| | - Luis Valdés
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Servicio de Neumología, Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
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Jakubczyk M, Lipka I, Pawęska J, Niewada M, Rdzanek E, Zaletel J, Ramírez de Arellano A, Doležal T, Chekorova Mitreva B, Nagy B, Petrova G, Šarić T, Yfantopoulos J, Czech M. Cost of severe hypoglycaemia in nine European countries. J Med Econ 2016; 19:973-82. [PMID: 27163169 DOI: 10.1080/13696998.2016.1188823] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Complications contribute largely to the economic gravity of diabetes mellitus (DM). How they arise and are treated differs substantially between countries. This paper assesses the total annual, direct, and indirect cost of severe hypoglycemia events (SHEs) in nine European countries: Bulgaria, Croatia, the Czech Republic, Greece, Hungary, Macedonia/the former Yugoslav Republic of Macedonia (MK), Poland, Slovenia, and Spain. METHODS Data was collected on epidemiology, treatment structure, SHE-driven resource consumption, and unit costs. Two systematic reviews-on the SHE rates and the resources used for treatment-and data on the days-of-work lost due to SHE along with salaries and employment rates were used. The total SHE cost in each country was calculated and how the differences are driven by individual parameters was analysed. RESULTS The annual costs of SHEs varied in absolute terms from €379,951.25 in MK up to €58,429,684.40 in Spain, or-when expressed per one drug-treated DM patient-from €5.47 in Bulgaria up to €17.74 in Spain. Indirect cost constituted between 6.01% (MK) and 26.49% (Hungary) of the total cost. The differences between countries are driven mostly by the cost of treating a single event, and this is related to general differences in prices. LIMITATIONS The main limitation is the lack of good quality data in some parts, and the necessity to use mean-value imputations, experts' opinions, etc. Additionally, we only considered DM treatment as the SHE driver, while other elements, e.g. style of living, may contribute substantially. CONCLUSIONS A common framework can be applied to estimate the economic burden of SHE in various countries, allowing one to identify the drivers of differences in cost. Treating DM is complex, and so no resolute conclusions ought to be drawn as to whether SHE management is better in one country than another.
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Affiliation(s)
- Michał Jakubczyk
- a Decision Analysis and Support Unit, Warsaw School of Economics , Poland
| | - Izabela Lipka
- b HealthQuest spółka z ograniczoną odpowiedzialnością Sp. K , Warsaw , Poland
| | - Justyna Pawęska
- b HealthQuest spółka z ograniczoną odpowiedzialnością Sp. K , Warsaw , Poland
| | - Maciej Niewada
- c Department of Experimental and Clinical Pharmacology , Medical University of Warsaw , Poland
| | - Elżbieta Rdzanek
- b HealthQuest spółka z ograniczoną odpowiedzialnością Sp. K , Warsaw , Poland
| | - Jelka Zaletel
- d Department of Endocrinology, Diabetes and Metabolic Diseases , University Medical Centre , Ljubljana , Slovenia
| | | | - Tomáš Doležal
- f Institute of Health Economics and Technology Assessment , Prague , the Czech Republic
- g Department of Pharmacology, 2nd Faculty of Medicine , Prague , the Czech Republic
| | | | - Bence Nagy
- i Healthware Consulting Ltd , Budapest , Hungary
| | - Guenka Petrova
- j Department of Social Pharmacy and Pharmacoeconomics, Faculty of Pharmacy , Medical University of Sofia , Bulgaria
| | - Tereza Šarić
- k Promeritus savjetovanje Ltd. , Zagreb , Croatia
| | - John Yfantopoulos
- l School of Economics and Political Science , University of Athens , Greece
| | - Marcin Czech
- m Department of Pharmacoeconomics , Medical University of Warsaw , Poland
- n Business School, Warsaw University of Technology , Poland
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