Survival of patients with diabetes mellitus by residential area in Colombia, 2008-2017

Objectives To estimate the survival in a dynamic cohort of patients with diabetes mellitus (DM) affiliated to a public health insurer in Colombia. Methods Retrospective cohort study (2008 - 2017) of 29,286 patients diagnosed with DM affiliated to a public health insurer, grouped by residence area (urban and rural). Sociodemographic variables and mortality incidence were analyzed. Survival curves were estimated using Kaplan-Meier (KM), Log-Rank significance test and Cox regression models to identify risk factors mortality. Results The average annual mortality rate was 2.2 / 100persons-year [CI95% = 2.1-2.3]. In the fourth year of the study, the probability of survival in the urban area was 88.7% [CI95% = 87.8-89.6%] and in the rural area it was 83.9% [CI95% = 81.1% -86.3 %]. For the last year the gap tends to increase; in the urban area the probability of survival was 43.4% [CI95% = 37.8% -48.8%], while in the rural area it was 19.83% [CI95% = 9.9% -32.2%]. The Logan-Rank test shows a higher diabetic death risk in patients living in rural areas (Chi2 = 27.23, p-value = 0.00 and NS = 5%). The Cox regression indicate that a diabetic patient from the rural area, presents a death risk of 26.3% [CI95% = 17.2% -34.5%] greater than the urban patients. In both areas, death probability increases with age (1048) [CI95% = 1.04-1.05]. Conclusions The survival probability remained high during the first two years and then decreases at a higher rate in the rural area. There is a significant gap in services access and / or medicines for the control of DM at the urban-rural level. A medium-term policy would be the implementation of DM risk management programs and the timely supply of medicines to patients in rural areas.

• Autores: Arrieta Arrieta, A; Marrugo Arnedo, C; Florez Tanus, A; Marrugo, R; Herrera, D; Gomez de la Rosa, F; Alvis-Guzmán, N
• Tipo de recurso: Article of journal
• Fecha de publicación: 2018
• Institución: Corporación Universidad de la Costa
• Repositorio: REDICUC - Repositorio CUC
• Idioma: eng
• OAI Identifier: oai:repositorio.cuc.edu.co:11323/4712
• Acceso en línea: https://hdl.handle.net/11323/4712; https://repositorio.cuc.edu.co/
• Palabra clave: Supervivencia; Cohorte dinámica de pacientes con diabetes mellitus; Salud pública en Colombia; Survival; Dynamic cohort of patients with diabetes mellitus; Public health in Colombia
• Rights: openAccess
• License: Attribution-NonCommercial-ShareAlike 4.0 International