Does the hospitalization after a cancer diagnosis modify adherence to process indicators of diabetes care quality?
OBJECTIVE
This study was designed to answer the question whether surgery due to newly diagnosed cancer may modify quality of diabetes' management, as suggested by current guidelines.


METHODS
Adherence to guideline composite indicator (GCI), a process indicator including one annual assessment of HbA1c and at least two among eye examination, serum lipids measurement and microalbuminuria, was evaluated between years 2011-2012 and 2014-2015 in 158,069 diabetic patients living in Tuscany, Italy, on 1 January 2011 and surviving on 31 December 2015, of whom 661 were hospitalized in index year 2013 for a surgery procedure due to a newly incident cancer. Difference in GCI modification (DELTA_GCI) of these patients was compared with that of diabetic people without cancer, strictly matched for main confounders by means of a propensity score.


RESULTS
In diabetic patients with cancer, GCI adherence increased by about 8 % between years 2011-2012 and 2014-2015. When compared with controls, DELTA_GCI increased by 6 % in cancer group compared with controls (p < 0.05), but any significance was lost after matching the groups by propensity score (3 %; p = NS).


CONCLUSIONS
Our study suggests that a hospitalization for a surgical procedure due to a newly diagnosed cancer does not influence the compliance to a quality process indicator of diabetes care such as GCI.
Agenzia Regionale Sanità Toscana, Via Pietro Dazzi 1, 50141, Florence, Italy.
Laura
L
Policardo
Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy.
Alessandro
A
Barchielli
Agenzia Regionale Sanità Toscana, Via Pietro Dazzi 1, 50141, Florence, Italy. gseghier@tin.it.
Giuseppe
G
Seghieri
Agenzia Regionale Sanità Toscana, Via Pietro Dazzi 1, 50141, Florence, Italy.
Paolo
P
Francesconi
D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000175:diagnosis / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000601:surgery; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care / Q000706:statistics & numerical data; D016903:Drug Monitoring
Cancer; Diabetes; Guideline composite indicator; Hospitalization