Variability in the Control of Type 2 Diabetes in Primary Care and Its Association with Hospital Admissions for Vascular Events. The APNA Study
Type 2 diabetes (T2D) is associated with increased cardiovascular morbidity, mortality, and hospital admissions. This study aimed to analyze how the differences in delivered care (variability of glycosylated hemoglobin (HbA1c) achieved targets) affect hospital admissions for cardiovascular events (C...
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| Veröffentlicht in: | Journal of clinical medicine 2021-12, Vol.10 (24), p.5854 |
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| description | Type 2 diabetes (T2D) is associated with increased cardiovascular morbidity, mortality, and hospital admissions. This study aimed to analyze how the differences in delivered care (variability of glycosylated hemoglobin (HbA1c) achieved targets) affect hospital admissions for cardiovascular events (CVEs) in T2D patients. Methods: We analyzed the electronic records in primary care health centers at Navarra (Spain) and hospital admission for CVEs. We followed 26,435 patients with T2D from 2012 to 2016. The variables collected were age, sex, health center, general practitioner practice (GPP), and income. The clinical variables were diagnosis of T2D, weight, height, body mass index (BMI), blood pressure (BP), HbA1c, low-density lipoprotein cholesterol (LDL-C), smoking, and antecedents of CVEs. We calculated, in each GPP practice, the proportion of patients with HbA1c ≥ 9. A non-hierarchical K-means cluster analysis classified GPPs into two clusters according to the level of compliance with HbA1C ≥ 9% control indicators. We used logistic and Cox regressions. Results: T2D patients had a higher probability of admission for CVEs when they belonged to a GPP in the worst control cluster of HbA1C ≥ 9% (HR = 1.151; 95% CI, 1.032-1.284). |
| doi_str_mv | 10.3390/jcm10245854 |
| format | Article |
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The APNA Study</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>PubMed Central</source><creator>Guillen-Aguinaga, Sara ; Forga, Luis ; Brugos-Larumbe, Antonio ; Guillen-Grima, Francisco ; Guillen-Aguinaga, Laura ; Aguinaga-Ontoso, Ines</creator><creatorcontrib>Guillen-Aguinaga, Sara ; Forga, Luis ; Brugos-Larumbe, Antonio ; Guillen-Grima, Francisco ; Guillen-Aguinaga, Laura ; Aguinaga-Ontoso, Ines</creatorcontrib><description>Type 2 diabetes (T2D) is associated with increased cardiovascular morbidity, mortality, and hospital admissions. This study aimed to analyze how the differences in delivered care (variability of glycosylated hemoglobin (HbA1c) achieved targets) affect hospital admissions for cardiovascular events (CVEs) in T2D patients. Methods: We analyzed the electronic records in primary care health centers at Navarra (Spain) and hospital admission for CVEs. We followed 26,435 patients with T2D from 2012 to 2016. The variables collected were age, sex, health center, general practitioner practice (GPP), and income. The clinical variables were diagnosis of T2D, weight, height, body mass index (BMI), blood pressure (BP), HbA1c, low-density lipoprotein cholesterol (LDL-C), smoking, and antecedents of CVEs. We calculated, in each GPP practice, the proportion of patients with HbA1c ≥ 9. A non-hierarchical K-means cluster analysis classified GPPs into two clusters according to the level of compliance with HbA1C ≥ 9% control indicators. We used logistic and Cox regressions. Results: T2D patients had a higher probability of admission for CVEs when they belonged to a GPP in the worst control cluster of HbA1C ≥ 9% (HR = 1.151; 95% CI, 1.032-1.284).</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10245854</identifier><identifier>PMID: 34945149</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Age ; Body mass index ; Clinical medicine ; Cluster analysis ; Compliance ; Diabetes ; Disease prevention ; Family physicians ; Health facilities ; Hospitals ; Low income groups ; Medical records ; Medical referrals ; Mortality ; Obesity ; Patient admissions ; Population ; Primary care ; Risk factors ; Socioeconomic factors ; Software</subject><ispartof>Journal of clinical medicine, 2021-12, Vol.10 (24), p.5854</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-c9818f82f39759a669c83070b5544ade418b80bc483aafd0d2c202ee8c2b0b6f3</citedby><cites>FETCH-LOGICAL-c409t-c9818f82f39759a669c83070b5544ade418b80bc483aafd0d2c202ee8c2b0b6f3</cites><orcidid>0000-0002-2882-930X ; 0000-0001-7594-6755 ; 0000-0003-4748-9520 ; 0000-0001-9749-8076 ; 0000-0001-7789-133X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703537/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703537/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,883,27911,27912,53778,53780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34945149$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guillen-Aguinaga, Sara</creatorcontrib><creatorcontrib>Forga, Luis</creatorcontrib><creatorcontrib>Brugos-Larumbe, Antonio</creatorcontrib><creatorcontrib>Guillen-Grima, Francisco</creatorcontrib><creatorcontrib>Guillen-Aguinaga, Laura</creatorcontrib><creatorcontrib>Aguinaga-Ontoso, Ines</creatorcontrib><title>Variability in the Control of Type 2 Diabetes in Primary Care and Its Association with Hospital Admissions for Vascular Events. The APNA Study</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Type 2 diabetes (T2D) is associated with increased cardiovascular morbidity, mortality, and hospital admissions. This study aimed to analyze how the differences in delivered care (variability of glycosylated hemoglobin (HbA1c) achieved targets) affect hospital admissions for cardiovascular events (CVEs) in T2D patients. Methods: We analyzed the electronic records in primary care health centers at Navarra (Spain) and hospital admission for CVEs. We followed 26,435 patients with T2D from 2012 to 2016. The variables collected were age, sex, health center, general practitioner practice (GPP), and income. The clinical variables were diagnosis of T2D, weight, height, body mass index (BMI), blood pressure (BP), HbA1c, low-density lipoprotein cholesterol (LDL-C), smoking, and antecedents of CVEs. We calculated, in each GPP practice, the proportion of patients with HbA1c ≥ 9. A non-hierarchical K-means cluster analysis classified GPPs into two clusters according to the level of compliance with HbA1C ≥ 9% control indicators. We used logistic and Cox regressions. Results: T2D patients had a higher probability of admission for CVEs when they belonged to a GPP in the worst control cluster of HbA1C ≥ 9% (HR = 1.151; 95% CI, 1.032-1.284).</description><subject>Age</subject><subject>Body mass index</subject><subject>Clinical medicine</subject><subject>Cluster analysis</subject><subject>Compliance</subject><subject>Diabetes</subject><subject>Disease prevention</subject><subject>Family physicians</subject><subject>Health facilities</subject><subject>Hospitals</subject><subject>Low income groups</subject><subject>Medical records</subject><subject>Medical referrals</subject><subject>Mortality</subject><subject>Obesity</subject><subject>Patient admissions</subject><subject>Population</subject><subject>Primary care</subject><subject>Risk factors</subject><subject>Socioeconomic factors</subject><subject>Software</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkV9LHDEUxUOxVLE-9V0u-CKUtfk3k8yLMGxtFUQFt76GTCbjZpmdbJOMsl_Cz9xs18rWvNyQ--PkHA5CXwg-Y6zC3xZmSTDlhSz4B3RAsRATzCTb27nvo6MYFzgfKTkl4hPaZ7ziBeHVAXp50MHpxvUurcENkOYWpn5IwffgO5itVxYofM-ITTZuiLvgljqsYaqDBT20cJUi1DF643RyfoBnl-Zw6ePKJd1D3S5djPk9QucDPOhoxl4HuHiyQ4pnMMsf1nc3NdynsV1_Rh873Ud79DoP0a8fF7Pp5eT69ufVtL6eGI6rNDGVJLKTtGOVKCpdlpWRDAvcFAXnurWcyEbixnDJtO5a3FJDMbVWGtrgpuzYITrf6q7GZmlbk70E3avVNpvy2qn_N4Obq0f_pKTArGAiC5y-CgT_e7QxqRzT2L7Xg_VjVLQknNJS_EVP3qELP4Yhx9tQVEjBJMnU1y1lgo8x2O7NDMFqU7XaqTrTx7v-39h_xbI_GEikyQ</recordid><startdate>20211214</startdate><enddate>20211214</enddate><creator>Guillen-Aguinaga, Sara</creator><creator>Forga, Luis</creator><creator>Brugos-Larumbe, Antonio</creator><creator>Guillen-Grima, Francisco</creator><creator>Guillen-Aguinaga, Laura</creator><creator>Aguinaga-Ontoso, Ines</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2882-930X</orcidid><orcidid>https://orcid.org/0000-0001-7594-6755</orcidid><orcidid>https://orcid.org/0000-0003-4748-9520</orcidid><orcidid>https://orcid.org/0000-0001-9749-8076</orcidid><orcidid>https://orcid.org/0000-0001-7789-133X</orcidid></search><sort><creationdate>20211214</creationdate><title>Variability in the Control of Type 2 Diabetes in Primary Care and Its Association with Hospital Admissions for Vascular Events. The APNA Study</title><author>Guillen-Aguinaga, Sara ; Forga, Luis ; Brugos-Larumbe, Antonio ; Guillen-Grima, Francisco ; Guillen-Aguinaga, Laura ; Aguinaga-Ontoso, Ines</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-c9818f82f39759a669c83070b5544ade418b80bc483aafd0d2c202ee8c2b0b6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Body mass index</topic><topic>Clinical medicine</topic><topic>Cluster analysis</topic><topic>Compliance</topic><topic>Diabetes</topic><topic>Disease prevention</topic><topic>Family physicians</topic><topic>Health facilities</topic><topic>Hospitals</topic><topic>Low income groups</topic><topic>Medical records</topic><topic>Medical referrals</topic><topic>Mortality</topic><topic>Obesity</topic><topic>Patient admissions</topic><topic>Population</topic><topic>Primary care</topic><topic>Risk factors</topic><topic>Socioeconomic factors</topic><topic>Software</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guillen-Aguinaga, Sara</creatorcontrib><creatorcontrib>Forga, Luis</creatorcontrib><creatorcontrib>Brugos-Larumbe, Antonio</creatorcontrib><creatorcontrib>Guillen-Grima, Francisco</creatorcontrib><creatorcontrib>Guillen-Aguinaga, Laura</creatorcontrib><creatorcontrib>Aguinaga-Ontoso, Ines</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guillen-Aguinaga, Sara</au><au>Forga, Luis</au><au>Brugos-Larumbe, Antonio</au><au>Guillen-Grima, Francisco</au><au>Guillen-Aguinaga, Laura</au><au>Aguinaga-Ontoso, Ines</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Variability in the Control of Type 2 Diabetes in Primary Care and Its Association with Hospital Admissions for Vascular Events. The APNA Study</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2021-12-14</date><risdate>2021</risdate><volume>10</volume><issue>24</issue><spage>5854</spage><pages>5854-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Type 2 diabetes (T2D) is associated with increased cardiovascular morbidity, mortality, and hospital admissions. This study aimed to analyze how the differences in delivered care (variability of glycosylated hemoglobin (HbA1c) achieved targets) affect hospital admissions for cardiovascular events (CVEs) in T2D patients. Methods: We analyzed the electronic records in primary care health centers at Navarra (Spain) and hospital admission for CVEs. We followed 26,435 patients with T2D from 2012 to 2016. The variables collected were age, sex, health center, general practitioner practice (GPP), and income. The clinical variables were diagnosis of T2D, weight, height, body mass index (BMI), blood pressure (BP), HbA1c, low-density lipoprotein cholesterol (LDL-C), smoking, and antecedents of CVEs. We calculated, in each GPP practice, the proportion of patients with HbA1c ≥ 9. A non-hierarchical K-means cluster analysis classified GPPs into two clusters according to the level of compliance with HbA1C ≥ 9% control indicators. We used logistic and Cox regressions. Results: T2D patients had a higher probability of admission for CVEs when they belonged to a GPP in the worst control cluster of HbA1C ≥ 9% (HR = 1.151; 95% CI, 1.032-1.284).</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>34945149</pmid><doi>10.3390/jcm10245854</doi><orcidid>https://orcid.org/0000-0002-2882-930X</orcidid><orcidid>https://orcid.org/0000-0001-7594-6755</orcidid><orcidid>https://orcid.org/0000-0003-4748-9520</orcidid><orcidid>https://orcid.org/0000-0001-9749-8076</orcidid><orcidid>https://orcid.org/0000-0001-7789-133X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central |
| subjects | Age Body mass index Clinical medicine Cluster analysis Compliance Diabetes Disease prevention Family physicians Health facilities Hospitals Low income groups Medical records Medical referrals Mortality Obesity Patient admissions Population Primary care Risk factors Socioeconomic factors Software |
| title | Variability in the Control of Type 2 Diabetes in Primary Care and Its Association with Hospital Admissions for Vascular Events. The APNA Study |
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