Hospital admission in children and adolescents with or without type 1 diabetes from Germany: An analysis of statutory health insurance data on 12 million subjects

Bohn, Barbara; Schwandt, Anke; Ihle, Peter; Icks, Andrea; Rosenbauer, Joachim; Karges, Beate; Holl, Reinhard W.

doi:10.1111/pedi.12621

Cited by 10 publications

(21 citation statements)

References 27 publications

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“…Between 2006 and 2013, the proportion of admissions for patients with T1D aged > 5-10 increased whereas the proportion aged > 15-20 decreased in the same period. In conformity with these results, our group reported recently that the chance of hospital admissions for pediatric patients with T1D compared to that without T1D in Germany was the highest for the age group > 5-10 [19]. One explanation is that the increase of T1D incidence in Europe is highest in the youngest children [16].…”

Section: Discussionsupporting

confidence: 71%

“…Preponderance of girls in inpatient rehabilitation conforms to a monocentric analysis considering inpatient rehabilitation for pediatric diabetes between 2004 and 2016 [11]. Girls with T1D have also a higher chance of hospital admission compared to boys, probably in consequence of more frequent acute diabetes-related complications [19]. Furthermore, we can speculate if the willingness to spend many weeks outside of the family is higher in girls than in boys.…”

Section: Discussionmentioning

confidence: 57%

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Inpatient Rehabilitation for Children and Adolescents With Diabetes in Germany Between 2006 and 2013

Auzanneau

Bohn

Schiel³

et al. 2018

Exp Clin Endocrinol Diabetes

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Introduction In Germany, inpatient rehabilitation is a well-established additive option in the therapeutic concept for children and adolescents with diabetes. However, its contribution in pediatric diabetes care is not known exactly. Our objective was to analyze inpatient rehabilitation in pediatric diabetes over eight years in Germany. Methods We requested secondary data from the German Statutory Pension Insurance Scheme to evaluate all completed inpatient rehabilitations for children and adolescents with diabetes (ICD-code E10-14) reimbursed by this institution between 2006 and 2013. For each type of diabetes, we analyzed the distribution of admissions by year, age-group, sex, nationality, and other documented diagnoses. All analyses were conducted via remote computing with IBM SPSS Version 24. Results Between 2006 and 2013, 5,403 admissions to inpatient rehabilitation for 4,746 children and adolescents with diabetes were documented. For type 1 diabetes (T1D; 88.5% of admissions), the number of yearly admissions increased from 458 in 2006 to 688 in 2013 (p=0.013), especially for age-group>5-10. The increase for type 2 diabetes (T2D) was not significant. Admissions were more frequent for girls (53.6%, p≤0.001), age>10-15 years (42.8%, p=0.001), and German nationality (98.5%). Obesity (T1D: 11.1%; T2D: 87.9%) and mental disorders (T1D: 11.6%; T2D: 27.4%) were the most frequent documented diagnoses in addition to diabetes. Conclusion This study provides a comprehensive overview of inpatient rehabilitation for children and adolescents with diabetes over many years in Germany. Until 2013, inpatient rehabilitation remained important in pediatric diabetes care, especially for children with mental disorders or obesity.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 57%

Inpatient Rehabilitation for Children and Adolescents With Diabetes in Germany Between 2006 and 2013

Auzanneau

Bohn

Schiel³

et al. 2018

Exp Clin Endocrinol Diabetes

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“…Diabetes in children and adolescents is associated with a high hospitalization rate compared to the general pediatric population [1][2][3]. However, inpatient care in pediatric diabetes varies a lot between countries.…”

Section: Introductionmentioning

confidence: 99%

“…Hospitalization in pediatric diabetes has mostly been studied with a focus on acute complications of T1D as severe hypoglycemia or ketoacidosis [6]. However, in many countries with a high hospitalization rate for pediatric diabetes, most of inpatient cases are not due to T1D complications [1,7,8]. In Germany for instance, elective hospital admissions for T1D without complications, like management of newly diagnosed diabetes, diabetes education or insulin dose adjustment, represent most of the inpatient cases in pediatric diabetes [1,7,9].…”

Section: Introductionmentioning

confidence: 99%

Hospitalization in Pediatric Diabetes: A Nationwide Analysis of all Admission Causes for Germany in 2015

Auzanneau

Rosenbauer

Icks

et al. 2019

Exp Clin Endocrinol Diabetes

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Introduction Regarding pediatric diabetes, hospital admission for acute complications of type 1 diabetes (T1D) has often been investigated, but little is known about other causes of hospitalization. This study aimed to explore the total burden of hospitalization in individuals with diabetes<20 years of age in Germany. Methods Using the German Diagnosis-Related Groups data for 2015, we examined the frequencies of hospitalization with diabetes (20 251 inpatient cases), stratified by diabetes type [T1D, type 2 diabetes (T2D), other specified diabetes types (T3D), and unclear diabetes], and without diabetes (1 269 631 inpatient cases). Using estimates of the population at risk with T1D, T2D, and without diabetes, we evaluated hospitalization rates (per patient-year) by Poisson regression. For T1D, T2D, and T3D, we investigated the most frequent diagnoses and the median length of stay. Most analyses were stratified by sex, age-group and east/west residence. Results Children and adolescents with diabetes had a 6 to 9 times higher hospitalization risk than peers without diabetes (hospitalization rate 0.09). The hospitalization rate was higher for T2D compared with T1D (0.84 vs. 0.53, P<0.001). In T2D, two-third of inpatient cases were not directly related to diabetes, and stay was shorter compared with T1D and T3D (3 vs. 4 and 5 days, respectively). In T1D, hospitalization was more frequent among girls than boys (0.58 vs. 0.49, P<0.001), and mostly due to “diabetes without complications” (65.7%). Hospitalization tended to be more frequent and longer in the youngest patients, and in those with east residence. Conclusion Hospitalization rate in pediatric diabetes in Germany remained high, especially for T2D patients, girls with T1D, and young children.

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“…The current, similar population data was presented by a group of German researchers. According to the German Information System for health care diabetes (n = 12030242), it has been documented that the number of hospitalizations for children with diabetes is 4-5 times higher, especially in the group of young children and adolescents [31].…”

Section: Discussionmentioning

confidence: 99%

Pediatric diabetes care: inpatient care in the Maps of Health Needs of Poland in 2014

Myśliwiec¹,

Jarosz-Chobot²,

Myśliwiec³

et al. 2019

Clinical Diabetology

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Health care provision for patients with diabetes mellitus is a considerable challenge to health policy due to the increasing number of its new cases, both in adults and in children. In Poland, hospital care for children with diabetes mellitus is centralized and most services are provided by university and provincial hospitals. In spite of the above the structure of the services provided varies widely from province to province, both in terms of the number of hospitalizations per 100,000 children, net migration rate, length of hospital the stay, and percentage of hospitalizations for acute complications. It is necessary to improve the societal and medical awareness regarding the signs and symptoms of diabetes in order to reduce the number of acute complications, including those at the time of diagnosis. Furthermore, it is crucial to make every effort to provide equal access to specialist diabetes care, thus to make it consistent with the standards. The high number and differences in the numbers, duration of hospitalizations of children with diabetes require further monitoring at a coordinated system of pediatric care. (Clin Diabetol 2018; 7, 6: 259-271)

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Hospital admission in children and adolescents with or without type 1 diabetes from Germany: An analysis of statutory health insurance data on 12 million subjects

Abstract: Children and adolescents with T1D in Germany had a 4 to 8 times higher hospitalization chance compared to children without T1D. The OR in T1D patients compared to peers were higher in girls than in boys. High rates of elective hospital admission in Germany may contribute to these results.

Cited by 10 publications

References 27 publications

Inpatient Rehabilitation for Children and Adolescents With Diabetes in Germany Between 2006 and 2013

Inpatient Rehabilitation for Children and Adolescents With Diabetes in Germany Between 2006 and 2013

Hospitalization in Pediatric Diabetes: A Nationwide Analysis of all Admission Causes for Germany in 2015

Pediatric diabetes care: inpatient care in the Maps of Health Needs of Poland in 2014

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