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

Skinner, Timothy C., Allen, Penny, Peach, Elizabeth, Browne, Jessica L., Pouwer, Frans, Speight, Jane and Dunbar, James A. 2013, Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES – Australia., Diabetes research and clinical practice, 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.
Author(s) Skinner, Timothy C.
Allen, Penny
Peach, Elizabeth
Browne, Jessica L.
Pouwer, Frans
Speight, Jane
Dunbar, James A.
Journal name Diabetes research and clinical practice
Volume number 100
Issue number 2
Start page 222
End page 229
Total pages 8
Publisher Elesvier BV
Place of publication Amsterdam, The Netherlands
Publication date 2013-05
ISSN 0168-8227
1872-8227
Keyword(s) diabetes management
health indicators
rural
access to healthcare
Summary 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.
Language eng
Field of Research 170106 Health, Clinical and Counselling Psychology
111712 Health Promotion
111714 Mental Health
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30056023

Document type: Journal Article
Collections: School of Psychology
Population Health
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