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

Gil, Joan and Sicras-Mainar, Antoni and Zucchelli, Eugenio (2017) Uncontrolled diabetes and health care utilisation : panel data evidence from Spain. European Journal of Health Economics. ISSN 1618-7598

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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.

Item Type:
Journal Article
Journal or Publication Title:
European Journal of Health Economics
Additional Information:
The final publication is available at Springer via http://dx.doi.org/10.1007%2Fs10198-017-0920-8
Uncontrolled Keywords:
?? uncontrolled diabetesbiomarkers health care utilisation panel count data jeconomics, econometrics and finance (miscellaneous)health policy ??
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Deposited On:
06 Oct 2017 19:33
Last Modified:
31 Dec 2023 00:51