Li,  Shu Qin; Guthridge S; Lawton, P; Burgess, Paul

Author(s)

Li, Shu Qin

Guthridge S

Lawton, P

Burgess, Paul

Publication Date

2019-08-19

Abstract

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

Affiliation

Northern Territory Department of Health, PO Box 40596, Casuarina, NT, 0811, Australia. shu.li@nt.gov.au..

Northern Territory Department of Health, PO Box 40596, Casuarina, NT, 0811, Australia.. Menzies School of Health Research, PO Box 41096, Casuarina, NT, 0811, Australia..

Menzies School of Health Research, PO Box 41096, Casuarina, NT, 0811, Australia..

Northern Territory Department of Health, PO Box 40596, Casuarina, NT, 0811, Australia..

Citation

BMC health services research 2019-08-19; 19(1): 582

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/31426768/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/7764

Subject

Care plan

Chronic disease

Diabetes

Northern Territory

Optimal care

Outcomes

Quality of care

Title

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

Type of document

Journal Article

Entity Type

Publication

Author(s)	Li, Shu Qin Guthridge S Lawton, P Burgess, Paul
Publication Date	2019-08-19
Abstract	To examine the association between delay in planned diabetes care and quality of outcomes. 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. 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). 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.
Affiliation	Northern Territory Department of Health, PO Box 40596, Casuarina, NT, 0811, Australia. shu.li@nt.gov.au.. Northern Territory Department of Health, PO Box 40596, Casuarina, NT, 0811, Australia.. Menzies School of Health Research, PO Box 41096, Casuarina, NT, 0811, Australia.. Menzies School of Health Research, PO Box 41096, Casuarina, NT, 0811, Australia.. Northern Territory Department of Health, PO Box 40596, Casuarina, NT, 0811, Australia..
Citation	BMC health services research 2019-08-19; 19(1): 582
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/31426768/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/7764
Subject	Care plan Chronic disease Diabetes Northern Territory Optimal care Outcomes Quality of care
Title	Does delay in planned diabetes care influence outcomes for aboriginal Australians? A study of quality in health care.
Type of document	Journal Article
Entity Type	Publication

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

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