Diabetes is one of the most common chronic diseases worldwide. The study aimed to present an epidemiological analysis of hospitalization related to diabetes mellitus in Poland between 2014 and 2020 as well as to analyze changes in diabetes-related hospital admissions before and during the COVID-19 pandemic. This study is a retrospective analysis of the national registry dataset of hospital discharge reports on diabetes-related hospitalizations in Poland between 2014 and 2020. The number of diabetes-related hospitalizations varied from 76,220 in 2016 to 45,159 in 2020. The hospitalization rate per 100,000 has decreased from 74.6 in 2019 to 53.0 in 2020 among patients with type 1 diabetes (percentage change: −28.9%). An even greater drop was observed among patients with type 2 diabetes: from 99.4 in 2019 to 61.6 in 2020 (percentage change: −38%). Both among patients with type 1 and type 2 diabetes, a decrease in hospitalization rate was higher among females than males (−31.6% vs. −26.7% and −40.9% vs. −35.2% respectively). When compared to 2019, in 2020, the in-hospital mortality rate increased by 66.7% (60.0% among males and 65.2% among females) among patients hospitalized with type 1 diabetes and by 48.5% (55.2% among females and 42.1% among males) among patients hospitalized with type 2 diabetes. Markable differences in hospitalization rate, duration of hospitalization, as well as in-hospital mortality rate by gender, were observed, which reveal health inequalities.
Type 1 diabetes mellitus (T1D) is, next to obesity and asthma, the most common chronic disease in children in Poland. T1D is not only a medical challenge, but it also affects all areas of a sick child’s life and family functionality. New forms of therapy facilitate the daily management of the disease, but their availability is limited and partly dependent on socioeconomic status. This study aimed to assess the incidence and interrelationships between the child’s health condition and the applied therapy model, and selected aspects of the child’s family functionality and access to health and care services. The survey involved 206 child and youth caregivers with T1D who are members of Facebook support groups. The analysis of the obtained results revealed the existence of links between family income level and the type of insulin therapy applied. Children from families with a better financial situation (subjective and objective) were more likely to have additional medical consultations and make more frequent control visits. In families with a higher level of income, the T1D-induced restriction of child activity was less frequent. Living outside of urban centers was associated with a reduced availability of care or educational facilities adapted to take care of a child with T1D. No statistically significant correlations were observed between demographic and economic factors and the child’s health status expressed by the occurrence of complications. The incidence of the latter, however, affected the child’s family situation.
Type 1 diabetes mellitus (T1D) is, next to obesity and asthma, the most common chronic disease in children in Poland. The results of T1D treatment strongly depend on the patient’s compliance with therapeutic recommendations, which entails the use of necessary health services. Based on a retrospective analysis of the data on health services provided in 2016–2020 to over 15.5 thousand patients with T1D in Poland, we assessed the compliance of the actual model of treatment of T1D in children with the current guidelines. It was found that only about 50% of patients received the number of diabetes consultations corresponding to the recognized standards, with about 15% of children with T1D remaining outside the public healthcare system. In the case of many outpatient services (ophthalmological, neurological, mental health), the number of consultations was extremely low—one order of magnitude lower than in general population and dropped even lower in 2020. This shows that the health needs of children with T1D are not being met within the public healthcare system. The COVID-19 pandemic caused significant limitations in access to healthcare in Poland. Compared to the pre-pandemic period there was a significant decrease (−27% compared to 2019) in the number of hospitalizations, and a substantial increase (+22% compared to 2019) in the number of diabetic ketoacidoses (DKA) cases. The proportion of hospitalizations caused by DKA rose to 8.9% compared to 7.3% in 2019.
Background: The global burden of diabetes mellitus is increasing, and diabetes poses a serious problem for the healthcare system. We aimed to characterize patients hospitalized due to diabetes in Poland in 2019 and identify factors associated with the risk of in-hospital death and prolonged hospitalization.Material/Methods: Data on all patients hospitalized due to diabetes in Poland in 2019 were taken from hospital discharge records collected by the National Institute of Public Health, Warsaw, Poland. The presence of comorbidities, in -hospi-tal mortality rate, and duration of hospitalization were analyzed separately for type 1 and type 2 diabetes.Results: In 2019, a total of 28 617 patients were admitted to the hospital due to type 1 diabetes and 38 138 patients due to type 2 diabetes. The prevalence of comorbidities was 55.2% among patients with type 1 diabetes and 78.9% among those with type 2 diabetes. The in-hospital mortality rates were 2.1% and 3.3%, respectively. For emergency admissions, the in-hospital mortality rate was 4.0% and 4.5%, respectively. Over 30% of patients were hospitalized for more than 7 days. Older age and respiratory diseases were the most critical factors asso-ciated with higher risk of in-hospital death in patients with type 1 or type 2 diabetes (P<0.001). Male sex, age, and presence of at least 1 comorbidity were associated (P<0.001) with a higher risk of prolonged hospitalization.Conclusions: Effective management of respiratory diseases in patients hospitalized due to diabetes, especially those admit-ted in an emergency, seems crucial to reduce the risk of in-hospital death.
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Lawer, fan & supporter of evidence-based public policies
Lawer, fan & supporter of evidence-based public policies