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Uncontrolled diabetes and health care utilisation: panel data evidence from Spain

Author

Listed:
  • Joan Gil

    (University of Barcelona (UB))

  • Antoni Sicras-Mainar

    (Badalona Serveis Assistencials (BSA))

  • Eugenio Zucchelli

    (Lancaster University)

Abstract

Despite size and relevance of uncontrolled diabetes, robust evidence on its effects on health care utilisation is very limited, especially among European countries. We employed longitudinal administrative data from Spain (2004–2010) to explore the relationship between uncontrolled type 2 diabetes and health care utilisation. We used a biomarker (glycated haemoglobin, HbA1c) to detect the presence of uncontrolled diabetes and explore its effects on both primary and secondary health care. We estimated a range of panel count data models, including negative binomials with random effects, dynamic and hurdle specifications to account for unobserved heterogeneity, previous utilisation and selection. We found uncontrolled diabetes in between 27 and 30% of patients of both genders. Our estimates suggested that although women appeared to systematically consume more health care compared to men, their consumption levels did not seem to be influenced by uncontrolled diabetes. Conversely, among men uncontrolled diabetes increased the average number of GP visits per year by between 3 and 3.4%, specialist visits by 5.3–6.1%, depending on specifications, and also extended annual hospital length of stay by 15%. We also found some evidence of heterogeneity in utilisation based on the level of uncontrolled diabetes among male individuals. Overall, our results suggested the need for different diabetes management plans depending on gender and levels of glycaemic control.

Suggested Citation

  • Joan Gil & Antoni Sicras-Mainar & Eugenio Zucchelli, 2018. "Uncontrolled diabetes and health care utilisation: panel data evidence from Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(6), pages 785-795, July.
  • Handle: RePEc:spr:eujhec:v:19:y:2018:i:6:d:10.1007_s10198-017-0920-8
    DOI: 10.1007/s10198-017-0920-8
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    References listed on IDEAS

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    Cited by:

    1. Ugolini, Cristina & Lippi Bruni, Matteo & Leucci, Anna Caterina & Fiorentini, Gianluca & Berti, Elena & Nobilio, Lucia & Moro, Maria Luisa, 2019. "Disease management in diabetes care: When involving GPs improves patient compliance and health outcomes," Health Policy, Elsevier, vol. 123(10), pages 955-962.
    2. Joan Gil & Paolo Li Donni & Eugenio Zucchelli, 2019. "Uncontrolled diabetes and health care utilisation: A bivariate latent Markov model approach," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1262-1276, November.
    3. Clémence Bussière & Nicolas Sirven & Thomas Rapp & Christine Sevilla‐Dedieu, 2020. "Adherence to medical follow‐up recommendations reduces hospital admissions: Evidence from diabetic patients in France," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 508-522, April.
    4. Simon Spika & Friedrich Breyer, 2020. "Domain-specific effects of physical activity on the demand for physician visits," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(5), pages 583-591, June.

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    More about this item

    Keywords

    Uncontrolled diabetes; Biomarkers; Health care utilisation; Panel count data;
    All these keywords.

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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