Does size matter? Hospital volume and resource use in paediatric diabetes care
Main finding · All-cause hospitalisationsResult — go to the resultOdds ratio 0.48 95% CI 0.32–0.72Authors' conclusion
Care provision patterns vary by hospital patient volume. Large hospitals had the lowest hospitalisation rates. The use of diabetes technology was not different between hospital patient volumes. Medium-sized hospitals showed the highest overall expenditure, but diabetes care costs were similar across hospital volumes.
Study context
- Population
- Dutch children with diabetes treated across 44 Dutch hospitals (2019–2020)
- Participants
- 5,082 children44 hospitals
- Exposure
- Large vs medium vs small hospitals by paediatric diabetes patient volume
- Outcome
- All-cause hospitalisations, consultations, technology and hospital expenditure, adjusted for age, sex, socio-economic status (SES) and hospital of treatment
Methodological detailshospital claims data, multilevel analysis
- Hospital claims data
- Multilevel analysis
Main finding
All-cause hospitalisations
Odds ratio
0.48
95% CI 0.32–0.72
P < 0.001
Largevs Small
OR 0.48 (95% CI 0.32–0.72); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Median
| Outcome | Small | Medium | Large | OR ≥7 consultations (95% CI) | P value | |
|---|---|---|---|---|---|---|
| Yearly paediatrician visitsLargevs SmallMultilevel analysis · significance attenuated in multilevel analysis | 6 | — not stated in the abstract | 7 | 1.89 (0.74–4.83) | P = 0.18 | |
| 0.20.5125OR ≥7 consultations (log scale) |
— not stated in the abstract
| Outcome | Small | Medium | Large |
|---|---|---|---|
| Overall expenditure per patient | — not stated in the abstract | mean €6434 (IQR €2555-7955) per patient | — not stated in the abstract |
— not stated in the abstract
Technology use (pump, rtCGM)
- Technology use varies between individual hospitals; pump usage and rtCGM showed no significant differences between hospital volumes
Overall expenditure per patient
- Mean overall expenditure was highest in medium-sized centres
- Difference in diabetes care costs not significant between hospital patient volumes
Original publication
Does size matter? Hospital volume and resource use in paediatric diabetes care. Diabet Med. Published 28 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →