Diabetes mellitus (DM) is a serious non-communicable disease (NCD) and relies on the patient being aware of their condition, proactive, and having adequate medical care. European countries healthcare models are aware of the impact of these variables. This study evaluates the impact of online health information seeking behavior (OHISB) during World Diabetes Mellitus Day (WDMD) in European countries from 2014 to 2019 by grouping countries according to the changes in citizens' search behavior, diabetes mellitus prevalence, the existence of National Health Plans (NHP), and their respective healthcare systems. We extracted data from Global Burden of Disease, Google Trends (GT), Public Health European Commission, European Coalition for Diabetes, and the Spanish Ministry of Health. First, we used the broken-line models to analyze significant changes in search trends (GT) in European Union member countries in the 30-day intervals before and after the WDMD (November 14) from 2014 to 2019. Then the results obtained were used in the second phase to group these countries by factor analysis of mixed data (FAMD) using the prevalence of DM, the existence of NHP, and health models in each country. The calculations were processed using R software (gtrendsR, segmented, Factoextra, and FactoMineR). We established changes in search trends before and after WDMD, highlighting unevenness among European countries. However, significant changes were mostly observed among countries with NHP. These changes in search trends, in addition to being significant, were reiterated over time and occurred especially in countries belonging to the Beveridge Model (Portugal, Spain, and Sweden) and with NHPs in place. Greater awareness of diabetes mellitus among the population and continuous improvements in NHP can improve the patients' quality of life, thus impacting in disease management and healthcare expenditure.
Inequalities in the equipment and use of information and communications technology (ICT) in Spanish households can lead to users being unable to access certain information or to carry out certain procedures. Accessibility to ICT is considered a social determinant of health (SDOH) because it can generate inequalities in access to information and in managing access to health services. In the face of a chronic illness such as diabetes mellitus (DM)—for which a comprehensive approach is complex and its complications have a direct impact on current healthcare systems—all the resources that patients may have are welcome. We aimed to analyze hospitalizations and amputations as direct consequences of DM among the autonomous communities of Spain (ACS) in 2019, along with socioeconomic factors related to health, including inequalities in access to ICT between territories, as well as citizens' interest in online information searches about DM. We used different databases such as that of the Ministerio de Sanidad (Spain's health ministry), Ministerio de Asuntos Económicos y transformación (Ministry of Economic Affairs and Digital Transformation), Google Trends (GT), and the Instituto Nacional de Estadística (Spain's national institute of statistics). We examined the data with R software. We employed a geolocation approach and performed multivariate analysis (specifically factor analysis of mixed data [FAMD]) to evaluate the aggregate interest in health information related to DM in different regions of Spain grounded in online search behavior. The use of FAMD allowed us to adjust the techniques of principal component analysis (PCA) and multiple correspondence analysis (MCA) to detect differences between the direct consequences of DM, citizen's interest in this non-communicable disease, and socioeconomic factors and inequalities in access to ICT in aggregate form between the country's different ACS. The results show how SDOH, such as poverty and education level, are related to the ACS with the highest number of homes that cite the cost of connection or equipment as the reason for not having ICT at home. These regions also have a greater number of hospitalizations due to DM. Given that in Spain, there are certain differences in accessibility in terms of the cost to households, in the case of DM, we take this issue into account from the standpoint of an integral approach by health policies.
INTRODUCTION:Diabetes Mellitus (DM) daily care requires personal effort.Patients must strictly:follow nutritional advice,implement lifestyle changes,and routinely and promptly take the drugs prescribed by health professionals among other guidelines.Eating Disorders(ED),such as anorexia and bulimia,are serious pathologies which can seriously affect the health of DM patients if they are not caught in time.However,if abuse of addictive substances is added to the scenario,the consequences for the health of the individual concerned can be very serious. OBJECTIVES:To analyse the variation in the cost of care processes of patients with DM(across all age groups)who also present with an ED and abuse addictive substances(caffeine,tobacco,alcohol,hallucinogens,cocaine,and opiates).These patients’ hospitalisation patterns will be considered for the time period between 2016 and 2018,and will include:type of discharge and admission,the origin of the patient,the type of care,and the patient’s needs during their hospital stay. MATERIAL AND METHODS: Database was provided by Grupo RECH–Red Española de Costes Hospitalarios–www.rechosp.org.The variables analysed included the main diagnoses of the aforementioned health problems.The following types of care were included:hospitalisation at home,in-house hospitalisation,major outpatient surgery,and emergencies,along with the type of patient discharge. METHODOLOGY:Descriptive statistics and Factorial Analysis of Mixed Data methodology(FAMD)were used to cluster the costs by main diagnoses due,jointly,to DM,ED,and the consumption of addictive substances.FactoMineR package has been used to obtain the outputs. RESULTS:There are significant increases in costs related to a patient's main diagnoses when dual pathology is included in the analysis.FAMD shows that surgical costs are similar to the use of substances such as caffeine,nicotine,hallucinogens and opiates,with alcohol standing out;that ward costs increase significantly for alcohol use;and that caffeine intake and hallucinogens are relevant in laboratory costs. CONCLUSIONS:These health problems generate distinct patterns of costs facing hospitals.They need to be identified and diagnosed before they become more serious making it necessary to establish the appropriate attention for the patient in time.
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