EARLY MORTALITY IN PATIENTS AFTER HOSPITALIZATION FOR DIABETIC CARE SENSITIVE CONDITIONS PRIMARY IN A MIDLE CITY OF BRAZIL: A WORRYING REALITY

Tuesday, 19 August 2014
Exhibit hall (Dena'ina Center)
Cláudia L Oliveira, PhD , Federal University of São João del-Rei, Divinópolis, Brazil
Aline Cristina S Lopes, PhD , Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
Cristiane M Padua, PhD , Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
Clareci S Cardoso, PhD , Federal University of São Joao del-Rei, Divinópolis, Brazil
INTRODUCTION:  Hospitalizations related to diabetes mellitus (DM ) and its complications are considered Ambulatory Care Sensitive Conditions (ACSC) and represent about 4.3% of hospital admissions. 

METHODS: A prospective cohort study that included all diabetic patients older than 18 years , hospitalized in the period July-October, 2011 in Divinópolis , MG, Brazil. After 18-24 months of discharged, we conducted the first visit of folow up. Data were collected containing sociodemographic , lifestyle, and food and medications, social support networks and quality of life, clinical and anthropometric examination, ECG  and blood tests 

RESULTS:  92 patients were eligible for the study and 72 have already been approached by phone or home visit . After about 20 months, there were 22 deaths, with a mortality rate of 30.6% in the study population. The mortality rate in patients 50-69 years was 36.4% and above 70 years was 43.5%. Approximately 20.4 % of patients had poor metabolic control, 18.2% had high blood pressure and 29.5% had signs of diabetic foot , 25% of patients were unable to walk to the nearest health Unit. In this study, diabetes contributed 126 years of potential life lost, which equates to an average of 10.5 years of life less per individual. 

CONCLUSIONS:  Around 50% of patients remained without adequate treatment after discharge. For those seeking health care , the costs of medication and maintaining a proper diet can also make it difficult for low-income patients benefit from health care. The percentage of complications observed in the study group points to a potential seriousness of the situation. Brazil advanced in building a comprehensive health system, but because of its complexity  improve their  quality and resolution is still a major challenge. The partnership between health services and universities are a viable possibility for diagnosis and intervention in these scenarios