Decrease in (Major) Amputations in Diabetics: A Secondary Data Analysis by AOK Rheinland/Hamburg

作     者：May, Melanie Hahn, Sebastian Tonn, Claudia Engels, Gerald Hochlenert, Dirk 

作者机构：AOK Rheinland Hamburg Unternehmensbereich Ambulante Versorgung Geschaftsbereich Selektivvertrage Kasernenstr 61 D-40213 Dusseldorf Germany AOK Rheinland Hamburg Unternehmensbereich M RSA Finanzen Controlling Geschaftsbereich Controlling Kasernenstr 61 D-40213 Dusseldorf Germany Chirurg Praxis Bayenthalgurtel Bayenthalgurtel 45 D-50968 Cologne Germany Wundchirurg St Vinzenz Hosp Koln Ltd Arzt Abt Merheimer Str 221 D-50733 Cologne Germany Ctr Diabetol Endoskopie & Wundheilung Merheimer Str 217 D-50733 Cologne Germany 

出 版 物：《JOURNAL OF DIABETES RESEARCH》 (实验肥胖糖尿病研究)

年 卷 期：2016年第2016卷第1期

页      面：6247045-6247045页

核心收录：

学科分类：1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 10[医学] 

主　　题：AMPUTATION DIABETICS DATA analysis LOG-linear models DISEASE management HEALTH programs INSURANCE companies 

摘      要：Aim. In two German regions with 11.1 million inhabitants, 6 networks for specialized treatment of DFS were implemented until 2008. Data provided for accounting purposes was analysed in order to determine changes in the rate of diabetics requiring amputations in the years before and after the implementation. Method. Data covering 2.9 million people insured by the largest insurance company between 2007 and 2013 was analysed by the use of log-linear Poisson regression adjusted for age, gender and region. Results. The rate of diabetics needing major amputations fell significantly by 9.5% per year (p 0.0001) from 217 to 126 of 100,000 patients per year. The rate of diabetics needing amputations of any kind fell from 504 to 419 of 100,000 patients per year (p = 0.0038). Discussion. The networks integrate health care providers in an organised system of shared care. They educate members of the medical community and the general public. At the same time, a more general disease management program for people with diabetes was implemented, which may also have contributed to this decrease. At the end of the observation period, the rate of diabetics requiring amputations was still high. For this reason, further expansion of organised specialized care is urgently needed.