Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia

Timothy Skinner, Penny Allen, Elizabeth Peach, Jessica Browne, Frans Pouwer, J Speight, James Dunbar

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Aim: To investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas.

    Methods: Diabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%).

    Results: Respondents from rural/regional (n = 1574, 48%) and metropolitan areas were represented equally (n = 1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69, 95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators.

    Conclusions: Despite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.

    Original languageEnglish
    Pages (from-to)222-229
    Number of pages8
    JournalDiabetes Research and Clinical Practice
    Volume100
    Issue number2
    DOIs
    Publication statusPublished - May 2013

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    Surveys and Questionnaires
    Hypoglycemic Agents
    Health Services
    Nurses
    Demography

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    Skinner, Timothy ; Allen, Penny ; Peach, Elizabeth ; Browne, Jessica ; Pouwer, Frans ; Speight, J ; Dunbar, James. / Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia. In: Diabetes Research and Clinical Practice. 2013 ; Vol. 100, No. 2. pp. 222-229.
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    title = "Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia",
    abstract = "Aim: To investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas. Methods: Diabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41{\%}) or T2DM (59{\%}). Results: Respondents from rural/regional (n = 1574, 48{\%}) and metropolitan areas were represented equally (n = 1700, 52{\%}). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95{\%} CI 0.83–0.97) and T2DM (RR 0.69, 95{\%} CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95{\%} CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95{\%} CI 1.07–1.36) or dietician (RR 1.17, 95{\%} CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators. Conclusions: Despite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.",
    author = "Timothy Skinner and Penny Allen and Elizabeth Peach and Jessica Browne and Frans Pouwer and J Speight and James Dunbar",
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    Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia. / Skinner, Timothy; Allen, Penny; Peach, Elizabeth; Browne, Jessica; Pouwer, Frans; Speight, J; Dunbar, James.

    In: Diabetes Research and Clinical Practice, Vol. 100, No. 2, 05.2013, p. 222-229.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia

    AU - Skinner, Timothy

    AU - Allen, Penny

    AU - Peach, Elizabeth

    AU - Browne, Jessica

    AU - Pouwer, Frans

    AU - Speight, J

    AU - Dunbar, James

    PY - 2013/5

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    N2 - Aim: To investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas. Methods: Diabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%). Results: Respondents from rural/regional (n = 1574, 48%) and metropolitan areas were represented equally (n = 1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69, 95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators. Conclusions: Despite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.

    AB - Aim: To investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas. Methods: Diabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%). Results: Respondents from rural/regional (n = 1574, 48%) and metropolitan areas were represented equally (n = 1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69, 95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators. Conclusions: Despite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.

    U2 - 10.1016/j.diabres.2013.03.015

    DO - 10.1016/j.diabres.2013.03.015

    M3 - Article

    VL - 100

    SP - 222

    EP - 229

    JO - Diabetes Research and Clinical Practice

    JF - Diabetes Research and Clinical Practice

    SN - 0168-8227

    IS - 2

    ER -