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Does the hospitalization after a cancer diagnosis modify adherence to process indicators of diabetes care quality?

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Abstract

Aims

This study was designed to answer the question whether surgery due to newly diagnosed cancer may modify quality of diabetes’ management, as suggested by current guidelines.

Methods

Adherence to guideline composite indicator (GCI), a process indicator including one annual assessment of HbA1c and at least two among eye examination, serum lipids measurement and microalbuminuria, was evaluated between years 2011–2012 and 2014–2015 in 158,069 diabetic patients living in Tuscany, Italy, on 1 January 2011 and surviving on 31 December 2015, of whom 661 were hospitalized in index year 2013 for a surgery procedure due to a newly incident cancer. Difference in GCI modification (DELTA_GCI) of these patients was compared with that of diabetic people without cancer, strictly matched for main confounders by means of a propensity score.

Results

In diabetic patients with cancer, GCI adherence increased by about 8 % between years 2011–2012 and 2014–2015. When compared with controls, DELTA_GCI increased by 6 % in cancer group compared with controls (p < 0.05), but any significance was lost after matching the groups by propensity score (3 %; p = NS).

Conclusions

Our study suggests that a hospitalization for a surgical procedure due to a newly diagnosed cancer does not influence the compliance to a quality process indicator of diabetes care such as GCI.

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Author contribution

L.P. researched/analysed data and wrote part of the manuscript. She is moreover the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis; A.B. researched data and reviewed the manuscript; P.F. researched data and reviewed the manuscript; G.S. reviewed/researched data and wrote the manuscript.

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Authors and Affiliations

  1. Agenzia Regionale Sanità Toscana, Via Pietro Dazzi 1, 50141, Florence, Italy

    Laura Policardo, Giuseppe Seghieri & Paolo Francesconi

  2. Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy

    Alessandro Barchielli

Authors
  1. Laura Policardo
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  2. Alessandro Barchielli
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  3. Giuseppe Seghieri
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  4. Paolo Francesconi
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Corresponding author

Correspondence to Giuseppe Seghieri.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Human and animal rights disclosure

This article does not contain any studies with human or animal subjects performed by any of the author and its design does not allow to disclose patients' identity or other sensitive data. For this reason no approval by an Ethics Committee was required.

Informed consent disclosure

Each patient was assigned a unique identifier that was the same for all administrative databases. This identifier does not allow to disclose the patient’s identity and other sensitive data, and therefore, no informed consent was required from all patients for being included in the study.

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Managed by Antonio Secchi.

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Policardo, L., Barchielli, A., Seghieri, G. et al. Does the hospitalization after a cancer diagnosis modify adherence to process indicators of diabetes care quality?. Acta Diabetol 53, 1009–1014 (2016). https://doi.org/10.1007/s00592-016-0898-1

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  • DOI: https://doi.org/10.1007/s00592-016-0898-1

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