Quality of diabetes follow-up care and hospital admissions
Diabetes may lead to severe complications. For this reason, disease prevention and improvement of medical follow-up represent major public health issues. The aim of this study was to measure the impact of adherence to French follow-up guidelines on hospitalization of people with diabetes. We used insurance claims data from the years 2010 to 2013 collected for 52,027 people aged over 18, affiliated to a French social security provider and treated for diabetes. We estimated panel data models to explore the association between adherence to guidelines and different measures of hospitalization, controlling for socioeconomic characteristics, diabetes treatment and density of medical supply. The results show that adherence to four guidelines was associated with a significant decrease in hospital admissions, up to approximatively 30% for patients monitored for a complete lipid profile or microalbuminuria during the year. In addition, our analyses confirmed the strong protective effect of income and a significant positive correlation with good supply of hospital care. In conclusion, good adherence to French diabetes guidelines seems to be in line with the prevention of health events, notably complications, that could necessitate hospitalization.
KeywordsChronic disease follow-up Hospital admissions Panel data
This project was financed by the MGEN Foundation for Public Health. We would like to thank Marie-Hélène Jeanneret-Crettez, Pauline Chauvin and Pascale Lapie-Legouis for their contributions to the inception of this project. We wish to thank particularly Fabien Gilbert for giving so much help in building the dataset. We are also thankful to Thomas Barnay from the University of Rouen and Nicolas Sirven from the University of Paris Descartes for their helpful comments and discussions regarding the econometric modelling implemented in this project. The authors are also grateful to all who contributed richly to the interpretation of these data and to the improvement of the manuscript, notably the participants of the winter Health Economists’ Study Group (HESG) meeting in Manchester, and more precisely to our discussant Seamus Kent and the chair of our session Alastair Gray from the University of Oxford. We are also thankful to the participants of the Days of the French Health Economists (JESF) in Dijon, in particular to our discussants Anne-Sophie Aguadé and Grégoire de Lagasnerie from the French National Health Insurance Fund for Employees (CNAMTS), for the insightful comments we received.
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