National Health Index shows an increase and marked regional differences in diabetes burden in Finland

Abstract Background The National Health Index contributes to the data bases needed for monitoring population health and development of health promotion policy and social and healthcare services. It includes a Morbidity Index and a Work Ability Index. The Morbidity Index is built on seven sub-indexes estimating the prevalence of the main components of the overall disease burden. The aim of this study is to describe the five-year time trend and regional differences in diabetes burden in Finland. Methods Diabetes index is based on four register data sources: (1) diagnosis in out-patient care, (ICD-codes), (2) hospital discharge diagnosis (ICD-codes), (3) purchase of diabetes medication (ATC-codes), and (4) special reimbursement for diabetes medication. Both non-standardized and age-standardized indexes were calculated. The time trend analysis is based on three three-year periods: 2017-2019, 2018-2020 and 2019-2021 for the whole country and separately for 22 regions. Index value 100 represents the average national level in the last period. Results National diabetes index increased from 94.9 in the first to 100 in the last follow-up period. The age-standardized values were 96,7 and 100, respectively. In 2019-2021 Åland region had the lowest index value (64.2) followed by Helsinki city (72.6). The highest index value (134.5) was observed in South Savo region. Age-standardization reduced the differences between regions which, nevertheless, remained remarkable: 63.2, 84.8 and 106.7, respectively. Furthermore, the highest age-standardized index value (117,5) was observed in South Ostrobothnia region. Conclusions Diabetes burden is still increasing in Finland, and there are marked differences between regions. The increase and regional differences are partly explained by changes and differences in age-structure but also other (preventable) factors play an important role. In general, diabetes burden is highest in eastern and northern parts of the country. Key messages • Diabetes burden is still increasing in Finland, and there are marked differences between regions. • The increase and regional differences are partly explained by changes and differences in age-structure but also other (preventable) factors play an important role.