Survey of Spanish hospitals on diabetes care resources

Edelmiro Luis Menéndez Torre; Pedro Pujante Alarcón; Francisco Javier Basterra-Gortari; Gemma Rojo-Martínez; María Ángeles Santos Mata; Grupo de Epidemiología de la Sociedad Española de Diabetes

doi:10.1016/j.endien.2023.10.002

Survey of Spanish hospitals on diabetes care resources

Endocrinol Diabetes Nutr (Engl Ed). 2023 Oct 18:S2530-0180(23)00136-1. doi: 10.1016/j.endien.2023.10.002. Online ahead of print.

Authors

Edelmiro Luis Menéndez Torre¹, Pedro Pujante Alarcón², Francisco Javier Basterra-Gortari³, Gemma Rojo-Martínez⁴, María Ángeles Santos Mata⁵; Grupo de Epidemiología de la Sociedad Española de Diabetes

Affiliations

¹ Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain. Electronic address: edelangot@gmail.com.
² Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; CIBER de Enfermedades Raras (CIBERER), Oviedo, Spain.
³ Servicio de Endocrinología y Nutrición, Hospital Universitario de Navarra, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain.
⁴ Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Málaga, Spain.
⁵ Servicio de Pediatría, Hospital Maternoinfantil de Jerez, Cádiz, Spain.

PMID: 37863667
DOI: 10.1016/j.endien.2023.10.002

Abstract

Introduction: The quality of diabetes care varies from region to region. The objective of this study is to analyze the characteristics of care in different hospitals in Spain through a specific survey assessing different aspects of care for both children and adults.

Materials and methods: Cross-sectional observational voluntary survey study, sent to the heads of the Endocrinology and Pediatric Endocrinology Departments or Units in public hospitals with more than 150 beds, during the first semester of 2021. A total of 105 responses were obtained, 55.5% of the 189 requested, which corresponded to a population served of 31,782,409 people, representing almost 80% of the total population served.

Results: Patients with diabetes under 15 years of age are cared for by Pediatric Departments, but only 58% of them have a specific Diabetes Education Unit for children, and in 72% of the cases, there is one single nurse dedicated to these tasks, and not always full-time. Those over 15 years of age are attended by specialists in Endocrinology and Nutrition in 94.3 % of hospitals. There are Therapeutic Education Units in Diabetes in practically all hospitals (94.3%). However, Diabetes Day Hospitals exist in only 32 centres and cover 40.3% of the population, since in 22 provinces there are none. Virtual and telematic consultations, as well as retinography, are available in more than 70% of cases, but access to a Diabetic Foot Unit only in 54% of centres. Monographic technological consultations on diabetes have become widespread, but access to mental health specialists with diabetes training remains limited (24% of centres), and interdisciplinary (32%) or interlevel (12%) committees are very scarce.

Conclusion: Diabetes care in Spain shows great variability from one region to another, and some deficiencies have been detected that affect a large part of the population, such as access to Diabetic Foot Units, as well as mental health specialists with specific training. The presence of multidisciplinary and mixed committees between levels of care remains scarce.

Keywords: Atención a la diabetes; Diabetes care; Diabetes mellitus; Encuesta nacional; España; National survey; Spain.