Evaluating the impact of the diabetes mellitus strategy for the national health system: An interrupted time series analysis

Marta González-Touya, Rocío Carmona, Antonio Sarría-Santamera

Research output: Contribution to journalArticlepeer-review

Abstract

(1) Background: Diabetes mellitus is a significant public health problem. Macrovascular complications (stroke, acute myocardial infarction (AMI) and lower limb amputations (LLAs) represent the leading cause of morbi-mortality in DM. This work aims to evaluate the impact of the approval of the Diabetes Mellitus Strategy of the National Health System (SDM-NHS) on hospitalizations for those macrovascular complications related to DM; (2) Methods: Interrupted time series applying segmented regression models (Negative Binomial) adjusted for seasonality to data from hospital discharge records with a primary or secondary diagnosis of DM (code 250 ICD9MC); (3) Results: Between 2001 and 2015, there have been 7,302,750 hospital discharges with a primary or secondary diagnosis of DM. After the approval of the SDM-NHS, all the indicators showed a downward trend, modifying the previous trend in the indicators of AMI and LLA. The indicators of stroke and AMI also showed an immediate reduction in their rates; (4) Conclusions: After the approval of the SDM-NHS, an improvement has been observed in all the indicators of macrovascular complications of DM evaluated, although it is difficult to establish a causal relationship between the strategy and the effects observed. Interrupted time series is applicable for evaluating the impact of interventions in public health when experimental designs are not possible.

Original languageEnglish
Article number873
JournalHealthcare (Switzerland)
Volume9
Issue number7
DOIs
Publication statusPublished - Jul 2021

Keywords

  • Comorbidity
  • Diabetes mellitus
  • Health plan implementation
  • Interrupted time series
  • Predictive and preventive strategies
  • Public policies evaluation

ASJC Scopus subject areas

  • Health Informatics
  • Health Policy
  • Health Information Management
  • Leadership and Management

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