Center differences in diabetes treatment outcomes among children with type 1 diabetes: A nationwide study of 3866 Danish children

• DOI: 10.1111/pedi.13284
• Publication Date: 2021-11-12T07:42:26Z
• Authors: Niels Skipper; Peter R. Thingholm; Luise Borch; Amanda Gaulke; Tine L. M. Eriksen; Charlotte Sønderg...; Jannet Svensson
• Keywords: Danish; Single Center; Case mix index

Objectives: Mean differences in HbA 1c across centers are well established, but less understood.The aim was to assess whether patient case-mix can explain the variation mean between pediatric diabetes Denmark.The association , frequency of blood glucose monitoring (BGM), treatment modality, and center visits investigated. ResearchDesign Methods: This longitudinal nationwide study included 3,866 Danish children with type 1 from 2013-2017 (n= 12,708 child-year observations) 16 different centers.Mean proportion reaching target (HbA ≤58mmol/mol (7.5%))were compared using linear regression models.This done without adjustment for socioeconomic characteristics (patient case-mix). Results:The difference during follow-up 11.6mmol/mol [95% CI 7.9, 15.3] (1.1% 0.7, 1.4]) when comparing lowest vs. highest .The attenuated remained significant after (difference: 10.5mmol/mol 6.8, 14.2] (1.0% 0.6, 1.3])).Overall, 6.8% were explained by case-mix.Across centers, more frequent BGM associated lower insulin pump users number not . Conclusion:In a setting universal health care, large found, could be background, or use technology.Only