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Clinical burden of diabetes in Italy in 2018: a look at a systemic disease from the ARNO Diabetes Observatory

INTRODUCTION: Diabetes is a highly prevalent disease worldwide and represents a challenge for patients and healthcare systems. This population-based study evaluated diabetes burden in Italy in 2018 by assessing all aspects of outpatient and hospital care. RESEARCH DESIGN AND METHODS: We investigated...

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Autores principales: Bonora, Enzo, Cataudella, Salvatore, Marchesini, Giulio, Miccoli, Roberto, Vaccaro, Olga, Fadini, Gian Paolo, Martini, Nello, Rossi, Elisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7383948/
https://www.ncbi.nlm.nih.gov/pubmed/32713842
http://dx.doi.org/10.1136/bmjdrc-2020-001191
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author Bonora, Enzo
Cataudella, Salvatore
Marchesini, Giulio
Miccoli, Roberto
Vaccaro, Olga
Fadini, Gian Paolo
Martini, Nello
Rossi, Elisa
author_facet Bonora, Enzo
Cataudella, Salvatore
Marchesini, Giulio
Miccoli, Roberto
Vaccaro, Olga
Fadini, Gian Paolo
Martini, Nello
Rossi, Elisa
author_sort Bonora, Enzo
collection PubMed
description INTRODUCTION: Diabetes is a highly prevalent disease worldwide and represents a challenge for patients and healthcare systems. This population-based study evaluated diabetes burden in Italy in 2018 by assessing all aspects of outpatient and hospital care. RESEARCH DESIGN AND METHODS: We investigated data of 11 300 750 residents in local health districts contributing to ARNO Diabetes Observatory (~20% of Italian inhabitants). All administrative healthcare claims were analyzed to gather information on access to medical resources. Subjects with diabetes, identified by antihyperglycemic drug prescriptions, disease-specific copayment exemption and hospital discharge codes, were compared with age, sex and residency-matched non-diabetic individuals. RESULTS: We identified 697 208 subjects with ascertained diabetes, yielding a prevalence of 6.2% (6.5% in men vs 5.9% in women, p<0.001). Age was 69±15 (mean±SD). As compared with non-diabetic subjects, patients with diabetes received more prescriptions of any drugs (+30%, p<0.001), laboratory tests, radiologic exams and outpatient specialist consultations (+20%, p<0.001) and were hospitalized more frequently (+86%, p<0.001), with a longer stay (+1.4 days, p<0.001). Although cardiovascular diseases accounted for many hospital discharge diagnoses, virtually all diseases contributed to the higher rate of hospital admissions in diabetic subjects (235 vs 99 per 1000 person-years, p<0.001). Healthcare costs were >2-fold higher in subjects with diabetes, mainly driven by hospitalizations and outpatient care related to chronic complications rather than to glucose-lowering drugs, diabetes-specific devices, or metabolic monitoring. CONCLUSIONS: The burden of diabetes in Italy is particularly heavy and, as a systemic disease, it includes all aspects of clinical medicine, with consequent high expenses in all areas of healthcare.
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spelling pubmed-73839482020-08-10 Clinical burden of diabetes in Italy in 2018: a look at a systemic disease from the ARNO Diabetes Observatory Bonora, Enzo Cataudella, Salvatore Marchesini, Giulio Miccoli, Roberto Vaccaro, Olga Fadini, Gian Paolo Martini, Nello Rossi, Elisa BMJ Open Diabetes Res Care Epidemiology/Health Services Research INTRODUCTION: Diabetes is a highly prevalent disease worldwide and represents a challenge for patients and healthcare systems. This population-based study evaluated diabetes burden in Italy in 2018 by assessing all aspects of outpatient and hospital care. RESEARCH DESIGN AND METHODS: We investigated data of 11 300 750 residents in local health districts contributing to ARNO Diabetes Observatory (~20% of Italian inhabitants). All administrative healthcare claims were analyzed to gather information on access to medical resources. Subjects with diabetes, identified by antihyperglycemic drug prescriptions, disease-specific copayment exemption and hospital discharge codes, were compared with age, sex and residency-matched non-diabetic individuals. RESULTS: We identified 697 208 subjects with ascertained diabetes, yielding a prevalence of 6.2% (6.5% in men vs 5.9% in women, p<0.001). Age was 69±15 (mean±SD). As compared with non-diabetic subjects, patients with diabetes received more prescriptions of any drugs (+30%, p<0.001), laboratory tests, radiologic exams and outpatient specialist consultations (+20%, p<0.001) and were hospitalized more frequently (+86%, p<0.001), with a longer stay (+1.4 days, p<0.001). Although cardiovascular diseases accounted for many hospital discharge diagnoses, virtually all diseases contributed to the higher rate of hospital admissions in diabetic subjects (235 vs 99 per 1000 person-years, p<0.001). Healthcare costs were >2-fold higher in subjects with diabetes, mainly driven by hospitalizations and outpatient care related to chronic complications rather than to glucose-lowering drugs, diabetes-specific devices, or metabolic monitoring. CONCLUSIONS: The burden of diabetes in Italy is particularly heavy and, as a systemic disease, it includes all aspects of clinical medicine, with consequent high expenses in all areas of healthcare. BMJ Publishing Group 2020-07-26 /pmc/articles/PMC7383948/ /pubmed/32713842 http://dx.doi.org/10.1136/bmjdrc-2020-001191 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Epidemiology/Health Services Research
Bonora, Enzo
Cataudella, Salvatore
Marchesini, Giulio
Miccoli, Roberto
Vaccaro, Olga
Fadini, Gian Paolo
Martini, Nello
Rossi, Elisa
Clinical burden of diabetes in Italy in 2018: a look at a systemic disease from the ARNO Diabetes Observatory
title Clinical burden of diabetes in Italy in 2018: a look at a systemic disease from the ARNO Diabetes Observatory
title_full Clinical burden of diabetes in Italy in 2018: a look at a systemic disease from the ARNO Diabetes Observatory
title_fullStr Clinical burden of diabetes in Italy in 2018: a look at a systemic disease from the ARNO Diabetes Observatory
title_full_unstemmed Clinical burden of diabetes in Italy in 2018: a look at a systemic disease from the ARNO Diabetes Observatory
title_short Clinical burden of diabetes in Italy in 2018: a look at a systemic disease from the ARNO Diabetes Observatory
title_sort clinical burden of diabetes in italy in 2018: a look at a systemic disease from the arno diabetes observatory
topic Epidemiology/Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7383948/
https://www.ncbi.nlm.nih.gov/pubmed/32713842
http://dx.doi.org/10.1136/bmjdrc-2020-001191
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