Evidence map›Paper›PMID 27550651›Full record

ArticleBMJ open2016

Regional trends in avoidable hospitalisations due to complications among population with diabetes in Finland in 1996-2011: a register-based cohort study.

Kristiina Manderbacka, Martti Arffman, Sonja Lumme, Markku Lehikoinen, Klas Winell, Ilmo Keskimäki

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Kristiina ManderbackaService System Research Unit, National Institute for Health and Welfare, Helsinki, Finland.
Martti ArffmanService System Research Unit, National Institute for Health and Welfare, Helsinki, Finland.
Sonja LummeService System Research Unit, National Institute for Health and Welfare, Helsinki, Finland.
Markku LehikoinenDepartment of Social Services and Health Care, Health Centre of City of Helsinki, Helsinki, Finland Department of General Practice and Primary Health Care, Network of Academic Health Centres, University of Helsinki, Helsinki, Finland.
Klas WinellConmedic, Espoo, Finland Health Monitoring Unit, National Institute for Health and Welfare, Helsinki, Finland.
Ilmo KeskimäkiService System Research Unit, National Institute for Health and Welfare, Helsinki, Finland School of Health Sciences, University of Tampere, Tampere, Finland.
Finnish Institute for Health and Welfare · FIConMed (Finland) · FITampere University · FIUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDiabetes requires continuous medical care including prevention of acute complications and risk reduction for long-term complications. Diabetic complications impose a substantial burden on public health and care delivery. We examined trends in regional differences in hospitalisations due to diabetes-related complications among the total diabetes population in Finland. RESEARCH

designA longitudinal register-based cohort study 1996-2011 among a total population with diabetes in Finland.

participantsAll persons with diabetes identified from several administrative registers in Finland in 1964-2011 and alive on 1 January 1996. OUTCOME MEASURES: We examined hospitalisations due to diabetes-related short-term and long-term complications, uncomplicated diabetes, myocardial infarction, stroke, lower extremity amputation and end-stage renal disease (ESRD). We calculated annual age-adjusted rates per 10 000 person years and the systematic component of variation. Multilevel models were used for studying time trends in regional variation.

resultsThere was a steep decline in complication-related hospitalisation rates during the study period. The decline was relatively small in ESRD (30%), whereas rates of hospitalisations for short-term and long-term complications as well as uncomplicated diabetes diminished by about 80%. The overall correlation between hospital district intercepts and slopes in time was -0.72 (p<0.001) among men and -0.99 (p<0.001) among women indicating diminishing variation. Diminishing variation was found in each of the complications studied. The variation was mainly distributed at the health centre level.

conclusionsOur study suggests that the prevention of complications among persons with diabetes has improved in Finland between 1996 and 2011. The results further suggest that the prevention of complications has become more uniform throughout the country.

Indexed as

AdultAmputation, SurgicalDiabetes ComplicationsFemaleFinlandHospitalizationHumansKidney Failure, ChronicLongitudinal StudiesMaleMyocardial InfarctionRegistriesSex DistributionStrokeUnnecessary ProceduresPRIMARY CARE

Identifiers

PMID27550651
PMCPMC5013371
OpenAlexW2514010794

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.