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

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    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

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

    Cite this

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    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",
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    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 journalArticle

    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

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    U2 - 10.1186/s12913-019-4404-7

    DO - 10.1186/s12913-019-4404-7

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