BackgroundType 2 diabetes mellitus is associated with a diverse range of pathologies. The aim of the study was to determine the incidence of diabetes-related complications, the prevalence of coexistent chronic conditions and to report multimorbidity in people with type 2 diabetes living in the Basque Country.MethodsAdministrative databases, in four cross sections (annually from 2007 to 2011) were consulted to analyse 149,015 individual records from patients aged ≥35 years with type 2 diabetes mellitus. The data observed were: age, sex, diabetes-related complications (annual rates of acute myocardial infarction, major amputations and avoidable hospitalisations), diabetes-related pathologies (prevalence of ischaemic heart disease, renal failure, stroke, heart failure, peripheral neuropathy, foot ulcers and diabetic retinopathy) and other unrelated pathologies (44 diseases).ResultsThe annual incidence for each condition progressively decreased during the four-year period: acute myocardial infarction (0.47 to 0.40%), major amputations (0.10 to 0.08%), and avoidable hospitalisations (5.85 to 5.5%). The prevalence for diabetes-related chronic pathologies was: ischaemic heart disease (11.5%), renal failure (8.4%), stroke (7.0%), heart failure (4.3%), peripheral neuropathy (1.3%), foot ulcers (2.0%) and diabetic retinopathy (7.2%). The prevalence of multimorbidity was 90.4%. The highest prevalence for other chronic conditions was 73.7% for hypertension, 13.8% for dyspepsia and 12.7% for anxiety.ConclusionsIn the type 2 diabetes mellitus population living in the Basque Country, incidence rates of diabetes complications are not as high as in other places. However, they present a high prevalence of diabetes related and unrelated diseases. Multimorbidity is very common in this group, and is a factor to be taken into account to ensure correct clinical management.

Introduction: This paper reports the development and validation of a questionnaire to assess collaboration between clinical professionals from two different care levels (primary and specialised care), according to the clinicians' own perceptions. This questionnaire has been elaborated to be used as part of the monitoring and evaluation process of the integrated care pilots in the public Basque Health Service.

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IntroductionThis paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions.MethodsThis organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i) readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii) collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii) overall impact of integration through several indicators based on the Triple Aim Framework.ResultsThe measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.ConclusionThere is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

ResumenEl objetivo del presente trabajo fue estimar la variabilidad y las relaciones filogenéticas entre 6 razas de ganado criollo colombiano, cebú Brahman y la española Pirenaica, mediante el uso de 12 marcadores moleculares tipo microsatélite. El número promedio de alelos fue de 11.58 con los valores más altos para los marcadores HEL 13 y ETH 10. La heterocigocidad promedio de todas las razas fue de 0.7 y el coeficiente de endogamia fue de 0.097, con los valores más altos para la raza Romosinuano. Los mayores valores de diversidad se presentaron en la raza Casanareño. La distancia genética entre las razas criollas colombianas y la raza española Pirenaica fue amplia (0.7–1.7) indicando posiblemente poca intervención de esta raza en el origen de las razas criollas. En general, las mayores distancias genéticas se presentaron entre las razas de origen Bos taurus (razas criollas colombianas y Pirenaica) con respecto a la Bos indicus (Brahman).