The document presented, with the collaboration of the Spanish Society of Primary Care Physicians (SEMERGEN), the General Council of Official Nursing Colleges of Spain (CGE), the Spanish Society of General Practitioners and Family Medicine (SEMG), the Spanish Federation of Diabetes (FEDE), and endorsed by the Spanish Society of Health Managers (SEDISA), highlights the need for all autonomous communities to have these centers, as there is a great inequality throughout the territory.
Diabetes Day Hospitals have the capacity to offer «comprehensive, accessible, and tailored» outpatient care to each patient and should be accompanied by an outpatient care device that allows «immediate» access and bidirectional communication with Emergency Services, Primary Care, and Hospital Units.
«The importance of implementing these centers nationally on a twelve-hour uninterrupted schedule to provide quick, personalized, and specialized care to individuals affected by diabetes mellitus with acute or subacute decompensations or complications, reducing the pressure on Primary Care, hospital specialties, and Emergency Services,» stated Ignacio Bernabéu, president of the SEEN, during the presentation of the proposal.
THESE CENTERS ARE UNEVENLY DISTRIBUTED ACROSS SPAIN
Despite their advantages, Bernabéu regretted that currently, there are only 32 Diabetes Day Hospitals integrated into hospital centers, concentrated in some autonomous communities while others have none, even though 77% of consulted autonomous regions have highlighted the importance of having these centers.
On the other hand, the president of the SEEN Foundation (FSEEN), Javier Escalada, explained that this is not a tool of the Endocrinology service but is dedicated to providing «quick, immediate, and effective» actions for patients, also relieving other services.
«It is surprising that they are not more widespread. The data, although scarce, point to the need to expand this network of hospitals. Admissions plummet compared to the rest,» he added.
Fernando Gómez Peralta, coordinator of the Diabetes Area of the SEEN, emphasized that these structures are «for and by patients with diabetes,» who can avoid spending nights in the hospital, improving the cost-effectiveness of care, being «shorter in time,» and tailored to each user, all in connection with other specialists to reduce physical travel.
The Head of the Endocrinology and Nutrition Service at the Virgen Macarena University Hospital (Seville) and director of the Comprehensive Diabetes Plan of Andalusia, María Asunción Martínez-Brocca, expressed that these centers should have pathways to facilitate access and multidisciplinary teams led by endocrinologists and nurses, supported by nursing assistants or administrative staff.
Martínez-Brocca, also coordinator of the Health Management Group of the SED, emphasized that these services should also offer therapeutic and educational interventions so that people with diabetes can face the different challenges they may encounter, such as starting insulin therapy, stabilizing during a breakdown, early support after hospital discharge, or assisting pregnant women.
«The total number of professionals involved in a Diabetes Day Hospital should allow continuity in care in the morning and afternoon, and the ability to respond to the demand of the area it references, which is variable, so the number of professionals should be adjusted to that volume,» she added.
Regarding this, Elvira Pertega, a member of the General Nursing Council (CGE), stressed the need for nursing specialization focused on diabetes care and attention, something the organization is already working on with the Ministry of Health.
Antonio Lavado, President of the Spanish Diabetes Federation (FEDE), added that it would also be important to have podiatrists, nutritionists, and psychologists, as well as offering physical exercise programs, so that it functions as a comprehensive diabetes unit.
«The benefits for the patient would be tremendous. We believe it is a leap in improving the patient (…) It is important to provide therapeutic education in diabetes, which would reduce costs in the system and improve their quality of life. This is the ideal place to educate patients,» he added.
Ezequiel Arranz, a family doctor at the San Blas Health Center in Parla (Madrid) and coordinator of the Diabetes, Endocrinology, and Metabolism Working Group of SEMERGEN, stated that Primary Care would also benefit from these centers, enabling «direct communication» with Endocrinology services and contributing to resolving issues related to initiating and managing pharmacological treatment.
Similarly, this communication will allow the possibility of carrying out treatment for acute complications that do not involve a life-threatening risk, favoring continuity of care and improving coordination at different levels, also helping to relieve pressure on Primary Care.
THE IMPORTANCE OF HOSPITAL MANAGERS TO EXPAND THIS NETWORK
Francisco Pomares, a member of the SED, emphasized the importance of being able to convey «this value proposition» and «convince» hospital managers to expand the network of Diabetes Day Hospitals.
«Unfortunately, when it does not have a very striking impact from the outset, we have difficulties in finding arguments. Here we have to look for them in health indicators. Fewer complications, fewer admissions, fewer amputations…» he stated.
Additionally, he recalled that people treated in these centers show more satisfaction with care and are happier with the results.
In this regard, SEDISA representative Patricia Alonso affirmed that they do not need to be convinced, after which she asked for help in making it possible, sharing the opinion of the other experts on the benefits of Diabetes Day Hospitals.
However, she noted that it is not a «simple» task due to the need to find the necessary infrastructure, physical spaces, improve information systems, and address the challenge of the lack of professionals in the National Health System (SNS).
FUENTE