Regional peculiarities of hospitalizations and outpatient medical treatment among the adult population with established type 2 diabetes mellitus

Purpose. To analyze the indicators of hospitalization and outpatient visits of patients aged 18 years and older with type 2 diabetes mellitus (DM) in federal districts (FD) and regions of the Russian Federation from the perspective of the World Health Organization concept of ambulatory care sensitive conditions. Materials and methods. The analysis included data from the annual forms of federal statistics (forms No. 12 and No. 14), on the number of hospitalizations and the outpatient visits of patients aged 18 years and older diagnosed of type 2 diabetes (ICD10: E11) in 2022. Results. We analyzed the data of the federal statistics (forms No. 12 and No. 14) of the Federal District and the regions of the Russian Federation in 2022. It was found that in the North Caucasus Federal District, an increased level of adult hospitalization is associated with an increased ratio of the number of hospitalizations to the number of outpatient visits to the primary health care (PHC) facilities. At the same time, in FDs with adult outpatient visits is higher than the Russian average and adult hospitalization is higher than the Russian average (Ural, Central and Volga FDs). And vice versa, in FDs with adult outpatient visits is lower than the Russian average and adult hospitalization is lower than the Russian average (Southern, Far Eastern, Siberian and North-Western FDs). When analyzing the ratio of the number of hospitalizations to the number of outpatient visits to PHC facilities among the adult population, the highest indicator was recorded in the North Caucasus FD, while the heterogeneity of the indicator within the FD was one of the highest among the other FDs. The lowest indicator of the number of hospitalizations to the number of cases of treatment in PHC facilities among the adult population with type 2 DM was recorded in the Northwestern FD, while the heterogeneity of the indicator within the FD was the lowest among the other FGs. There was a high variability of the ratio both for all subjects of the Russian Federation and FDs. The ratio values ranged from 2,55 in the Novgorod Region to 31,39 in the Chechen Republic. Conclusion. Accounting for diseases that can be treated on an outpatient basis can become one of the tools for assessing the quality of medical care to the adult population in PHC facilities. However, before including this indicator as a criterion for assessing the quality of medical services, a deeper understanding of the reasons influencing its change is required. 

diabetes mellitus, hospitalization, outpatient care, primary health care, quality of medical care