Does delay in planned diabetes care influence outcomes for aboriginal Australians? A study of quality in health care

Shu Qin Li, Steven Guthridge, Paul Lawton, Paul Burgess

Research output: Contribution to journalArticleResearchpeer-review

1 Downloads (Pure)

Abstract

Background: To examine the association between delay in planned diabetes care and quality of outcomes.

Methods: A retrospective analysis of primary care and inpatient records for 2567 Aboriginal patients, with diabetes, living in 49 remote communities in the Northern Territory of Australia. Poisson regression was used to estimate the association between delay from diagnosis to documented diabetes care plan and three outcome measures: mean HbA1c level, most recent blood pressure and number of diabetes-related hospital admissions.

Results: Compared with no delay (< 60 days), patients with delay had increased risk of elevated mean HbA1c: 60 days to < 2 years, incidence rate ratio (IRR), 1.2 (95% CI:1.07-1.39); 2 years to < 4 years, incidence rate ratio (IRR), 1.2 (95% CI:1.04-1.45); 4 years and over, incidence rate ratio (IRR), 1.3 (95% CI:1.12-1.52). There was no evidence of association between delay and optimal blood pressure control. Risk of diabetes-related admission increased with increased delay. Compared with no delay the IRRs for delay were: 60 days to < 2 years, 1.2 (95% CI:1.07-1.42); 2 to < 4 years, 1.3 (95% CI: 1.15-1.58): and 4 years and over, 2.6 (95% CI,2.28-3.08).

Conclusion: The study found that a timely diabetes care plan was associated with better short-term blood glucose control and fewer diabetes-related admissions but not with improved blood pressure control. Delays may be a result of both patient and service-related factors.

Original languageEnglish
Article number582
Pages (from-to)1-7
Number of pages7
JournalBMC Health Services Research
Volume19
Issue number1
DOIs
Publication statusPublished - 19 Aug 2019

Fingerprint

Quality of Health Care
Blood Pressure
Incidence
Northern Territory
Blood Glucose
Inpatients
Primary Health Care
Outcome Assessment (Health Care)

Cite this

@article{7b4f04fdff624d3f864fe277675561db,
title = "Does delay in planned diabetes care influence outcomes for aboriginal Australians? A study of quality in health care",
abstract = "Background: To examine the association between delay in planned diabetes care and quality of outcomes. Methods: A retrospective analysis of primary care and inpatient records for 2567 Aboriginal patients, with diabetes, living in 49 remote communities in the Northern Territory of Australia. Poisson regression was used to estimate the association between delay from diagnosis to documented diabetes care plan and three outcome measures: mean HbA1c level, most recent blood pressure and number of diabetes-related hospital admissions. Results: Compared with no delay (< 60 days), patients with delay had increased risk of elevated mean HbA1c: 60 days to < 2 years, incidence rate ratio (IRR), 1.2 (95{\%} CI:1.07-1.39); 2 years to < 4 years, incidence rate ratio (IRR), 1.2 (95{\%} CI:1.04-1.45); 4 years and over, incidence rate ratio (IRR), 1.3 (95{\%} CI:1.12-1.52). There was no evidence of association between delay and optimal blood pressure control. Risk of diabetes-related admission increased with increased delay. Compared with no delay the IRRs for delay were: 60 days to < 2 years, 1.2 (95{\%} CI:1.07-1.42); 2 to < 4 years, 1.3 (95{\%} CI: 1.15-1.58): and 4 years and over, 2.6 (95{\%} CI,2.28-3.08). Conclusion: The study found that a timely diabetes care plan was associated with better short-term blood glucose control and fewer diabetes-related admissions but not with improved blood pressure control. Delays may be a result of both patient and service-related factors.",
keywords = "Care plan, Chronic disease, Diabetes, Northern Territory, Optimal care, Outcomes, Quality of care",
author = "Li, {Shu Qin} and Steven Guthridge and Paul Lawton and Paul Burgess",
year = "2019",
month = "8",
day = "19",
doi = "10.1186/s12913-019-4404-7",
language = "English",
volume = "19",
pages = "1--7",
journal = "BMC Health Services Research",
issn = "1472-6963",
publisher = "BioMed Central",
number = "1",

}

Does delay in planned diabetes care influence outcomes for aboriginal Australians? A study of quality in health care. / Li, Shu Qin; Guthridge, Steven; Lawton, Paul; Burgess, Paul.

In: BMC Health Services Research, Vol. 19, No. 1, 582, 19.08.2019, p. 1-7.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Does delay in planned diabetes care influence outcomes for aboriginal Australians? A study of quality in health care

AU - Li, Shu Qin

AU - Guthridge, Steven

AU - Lawton, Paul

AU - Burgess, Paul

PY - 2019/8/19

Y1 - 2019/8/19

N2 - Background: To examine the association between delay in planned diabetes care and quality of outcomes. Methods: A retrospective analysis of primary care and inpatient records for 2567 Aboriginal patients, with diabetes, living in 49 remote communities in the Northern Territory of Australia. Poisson regression was used to estimate the association between delay from diagnosis to documented diabetes care plan and three outcome measures: mean HbA1c level, most recent blood pressure and number of diabetes-related hospital admissions. Results: Compared with no delay (< 60 days), patients with delay had increased risk of elevated mean HbA1c: 60 days to < 2 years, incidence rate ratio (IRR), 1.2 (95% CI:1.07-1.39); 2 years to < 4 years, incidence rate ratio (IRR), 1.2 (95% CI:1.04-1.45); 4 years and over, incidence rate ratio (IRR), 1.3 (95% CI:1.12-1.52). There was no evidence of association between delay and optimal blood pressure control. Risk of diabetes-related admission increased with increased delay. Compared with no delay the IRRs for delay were: 60 days to < 2 years, 1.2 (95% CI:1.07-1.42); 2 to < 4 years, 1.3 (95% CI: 1.15-1.58): and 4 years and over, 2.6 (95% CI,2.28-3.08). Conclusion: The study found that a timely diabetes care plan was associated with better short-term blood glucose control and fewer diabetes-related admissions but not with improved blood pressure control. Delays may be a result of both patient and service-related factors.

AB - Background: To examine the association between delay in planned diabetes care and quality of outcomes. Methods: A retrospective analysis of primary care and inpatient records for 2567 Aboriginal patients, with diabetes, living in 49 remote communities in the Northern Territory of Australia. Poisson regression was used to estimate the association between delay from diagnosis to documented diabetes care plan and three outcome measures: mean HbA1c level, most recent blood pressure and number of diabetes-related hospital admissions. Results: Compared with no delay (< 60 days), patients with delay had increased risk of elevated mean HbA1c: 60 days to < 2 years, incidence rate ratio (IRR), 1.2 (95% CI:1.07-1.39); 2 years to < 4 years, incidence rate ratio (IRR), 1.2 (95% CI:1.04-1.45); 4 years and over, incidence rate ratio (IRR), 1.3 (95% CI:1.12-1.52). There was no evidence of association between delay and optimal blood pressure control. Risk of diabetes-related admission increased with increased delay. Compared with no delay the IRRs for delay were: 60 days to < 2 years, 1.2 (95% CI:1.07-1.42); 2 to < 4 years, 1.3 (95% CI: 1.15-1.58): and 4 years and over, 2.6 (95% CI,2.28-3.08). Conclusion: The study found that a timely diabetes care plan was associated with better short-term blood glucose control and fewer diabetes-related admissions but not with improved blood pressure control. Delays may be a result of both patient and service-related factors.

KW - Care plan

KW - Chronic disease

KW - Diabetes

KW - Northern Territory

KW - Optimal care

KW - Outcomes

KW - Quality of care

UR - http://www.scopus.com/inward/record.url?scp=85070917757&partnerID=8YFLogxK

U2 - 10.1186/s12913-019-4404-7

DO - 10.1186/s12913-019-4404-7

M3 - Article

VL - 19

SP - 1

EP - 7

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

IS - 1

M1 - 582

ER -