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A comparison of diabetes clinics with different emphasis on routine care, complications assessment and shared care

journal contribution
posted on 2008-08-01, 00:00 authored by N W Cheung, D K Yue, Mark KotowiczMark Kotowicz, P A Jones, J R Flack
OBJECTIVE: To compare clinical outcomes of patients attending diabetes clinics with different models of care. METHODS: Diabetes centres which participated in the Australian National Diabetes Information Audit and Benchmarking (ANDIAB) data collection were invited to nominate whether they provided (i) routine diabetes care only (model A), (ii) routine care and structured annual complications screening (model B) or (iii) annual review and complications screening in a system of shared care with general practitioners (model C). De-identified case data were extracted from ANDIAB and outcomes according to the three clinic models were compared. RESULTS: Data on 3052 patients from 18 diabetes centres were analysed. Centres which practised annual complications screening (models B and C) had higher rates of nephropathy and lipid screening and a higher rate of attainment of recommended blood pressure and glycated haemoglobin (HbA(1c)) targets. The implementation of appropriate treatment for patients who had not attained the targets was similar for all three clinic models. CONCLUSIONS: In our study, clinic models which incorporate a system of structured complications screening were more likely to have met screening guidelines. Patients in a shared-care model were at least as likely to have met management targets as those attending diabetes clinics for their routine care. Therefore, a system of shared care by general practitioners supported by annual review at a diabetes clinic may be an acceptable model which improves the capacity to manage large numbers of people with diabetes, without loss of quality of care.

History

Journal

Diabetic medicine

Volume

25

Issue

8

Pagination

974 - 978

Publisher

Wiley

Location

London, Eng.

eISSN

1464-5491

Language

eng

Publication classification

C Journal article; C1 Refereed article in a scholarly journal

Copyright notice

2008, The Authors