Association of socioeconomic status and hospital efficiency in Type-1 diabetic patients with ketoacidosis or diabetic coma: a secondary data analysis comparing nation-wide paediatric and adult admissions in France

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-09-04 DOI:10.1016/j.diabres.2025.112450

Yuanchen Xu , Karine Chevreul , Christel Dindorf , Élise Bismuth , Jean-Claude Carel , Morgane Michel

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引用次数: 0

Abstract

Aims

To study the association between socioeconomic status (SES) and hospital efficiency in Type 1 diabetes mellitus patients admitted for ketoacidosis or diabetic coma in mainland France, overall and in adults versus children.

Methods

An observational study was carried out using exhaustive national hospital discharge databases. It included all admissions discharged from 2013 to 2019. SES was assessed using an ecological measure divided into national quintiles, and efficiency by variations in patients’ length of stay (LOS) compared to mean national LOS and a comparison of production costs and revenues. Multilevel multivariable analyses were carried out to study the association.

Results

67,100 admissions were included. Multivariable analyses found a significant association between efficiency outcomes, SES and age. Compared to other age groups, children under 5 had higher LOS than the national mean and incurred higher costs than what hospitals were paid regardless of SES. In adults, there was a significant interaction between SES and age group, leading to significantly increased LOS and costs in adults from intermediate and/or lower SES groups.

Conclusions

Current payment methods using diagnosis-related groups may not adequately reflect the burden of Type 1 diabetes mellitus patients admitted for ketoacidosis or diabetic coma on hospitals.

查看原文本刊更多论文

伴有酮症酸中毒或糖尿病昏迷的1型糖尿病患者的社会经济地位与医院效率的关联：一项比较法国全国儿科和成人住院的二级数据分析。

目的：研究法国大陆因酮症酸中毒或糖尿病昏迷住院的1型糖尿病患者的社会经济地位（SES）与医院效率之间的关系，包括成人和儿童。方法：利用详尽的国家医院出院数据库进行观察性研究。它包括2013年至2019年所有出院的患者。SES的评估采用生态指标，分为国家五分位数，通过患者住院时间（LOS）与国家平均住院时间（LOS）的变化以及生产成本和收入的比较来评估效率。采用多水平多变量分析来研究其相关性。结果：纳入67,100例入院患者。多变量分析发现，效率结果、社会经济地位和年龄之间存在显著关联。与其他年龄组相比，5岁以下儿童的LOS高于全国平均水平，其费用高于医院支付的费用，无论其经济状况如何。在成人中，社会经济地位和年龄组之间存在显著的相互作用，导致中等和/或较低社会经济地位的成年人的LOS和成本显著增加。结论：目前使用诊断相关分组的支付方式可能不能充分反映医院收治的1型糖尿病酮症酸中毒或糖尿病昏迷患者的负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.