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

González-Touya M. Carmona R. Sarría-Santamera A.
July 2021 MDPI AG

Healthcare (Switzerland)
2021 #9 Issue 7

(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.

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

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Hospital Ramón y Cajal, Madrid, 28034, Spain
Institute of Health Carlos III, Madrid, 28029, Spain
Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, 020000, Kazakhstan

Hospital Ramón y Cajal
Institute of Health Carlos III
Department of Medicine

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