Elizabeth Jean Comino1, Md Fakhrul Islam2, Duong Thuy Tran3, Louisa Jorm4, Jeff Flack5, Bin Jalaludin6, Marion Haas7, Mark Fort Harris8. 1. Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: E.Comino@unsw.edu.au. 2. Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: f.islam@unsw.edu.au. 3. Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: Danielle.tran@unsw.edu.au. 4. Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: L.Jorm@unsw.edu.au. 5. Medicine, University of New South Wales, Sydney, NSW 2052, Australia; Diabetes Centre, Bankstown-Lidcombe Hospital, Eldridge Road, Bankstown, NSW 2200, Australia. Electronic address: Jeff.Flack@sswahs.nsw.gov.au. 6. Centre for Research, Evidence Management and Surveillance, Sydney and South Western Sydney Local Health Districts, Locked Bag 7017, Liverpool, NSW 1871, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney 2052, Australia. Electronic address: bin.jalaludin@sswahs.nsw.gov.au. 7. Centre for Health Economics Research and Evaluation, Faculty of Business, University of Technology, Sydney, PO Box 123, Level 4, 645 Harris Street Ultimo, Broadway, NSW 2007, Australia. Electronic address: Marion.Haas@chere.uts.edu.au. 8. Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: M.F.Harris@unsw.edu.au.
Abstract
AIMS: To explore the association of primary care and hospitalisation for people with diabetes. METHODS: The study comprised 20,433 diabetic participants in the Sax Institute's 45 and Up Study. Data on processes of care at recruitment (15 months) were extracted from the Department of Human Services Medicare database. Processes included continuity of primary care (47.1%), and claims for completion of an annual cycle of care (25.0%), GP management plan/team care arrangement (GPMP/TCA, 41.3%), review of GPMP/TCA (24.0%), and monitoring including HbA1c (62.7%). Hospitalisation (12 months) following recruitment was extracted from administrative data held by NSW Ministry of Health. Adjusted incidence rate ratios (aIRR) with 95% confidence interval were calculated. RESULTS: A hospital admission was reported for 33.0% of participants. Continuity of care (aIRR: 0.92 (95%CI: 0.89-0.96)), or claims for an annual cycle of care (aIRR: 0.77 (0.74-0.80)) or HbA1c testing (aIRR: 0.92 (0.89-0.96) were associated with a reduced likelihood of hospitalisation. While claims for preparation of GPMP/TCA were not associated with hospitalisation, a claim for review of GPMP/TCA was associated with a reduced likelihood of hospitalisation (aIRR: 0.92 (95%CI: 0.89 0.96)). CONCLUSIONS: This study has implications for hospital avoidance programmes suggesting that strengthening primary care may be more important than care coordination for this group of patients.
AIMS: To explore the association of primary care and hospitalisation for people with diabetes. METHODS: The study comprised 20,433 diabeticparticipants in the Sax Institute's 45 and Up Study. Data on processes of care at recruitment (15 months) were extracted from the Department of Human Services Medicare database. Processes included continuity of primary care (47.1%), and claims for completion of an annual cycle of care (25.0%), GP management plan/team care arrangement (GPMP/TCA, 41.3%), review of GPMP/TCA (24.0%), and monitoring including HbA1c (62.7%). Hospitalisation (12 months) following recruitment was extracted from administrative data held by NSW Ministry of Health. Adjusted incidence rate ratios (aIRR) with 95% confidence interval were calculated. RESULTS: A hospital admission was reported for 33.0% of participants. Continuity of care (aIRR: 0.92 (95%CI: 0.89-0.96)), or claims for an annual cycle of care (aIRR: 0.77 (0.74-0.80)) or HbA1c testing (aIRR: 0.92 (0.89-0.96) were associated with a reduced likelihood of hospitalisation. While claims for preparation of GPMP/TCA were not associated with hospitalisation, a claim for review of GPMP/TCA was associated with a reduced likelihood of hospitalisation (aIRR: 0.92 (95%CI: 0.89 0.96)). CONCLUSIONS: This study has implications for hospital avoidance programmes suggesting that strengthening primary care may be more important than care coordination for this group of patients.
Authors: Genevieve Coorey; Anna Campain; John Mulley; Tim Usherwood; Julie Redfern; Mark Harris; Nicholas Zwar; Sharon Parker; Enrico Coiera; David Peiris Journal: BMC Prim Care Date: 2022-06-21
Authors: Heidi Welberry; Margo Linn Barr; Elizabeth J Comino; Ben F Harris-Roxas; Elizabeth Harris; Shona Dutton; Tony Jackson; Debra Donnelly; Mark Fort Harris Journal: BMC Health Serv Res Date: 2019-11-07 Impact factor: 2.655
Authors: Margo Linn Barr; Heidi Welberry; Elizabeth J Comino; Ben F Harris-Roxas; Elizabeth Harris; Jane Lloyd; Sarah Whitney; Claire O'Connor; John Hall; Mark Fort Harris Journal: Prim Health Care Res Dev Date: 2019-10-23 Impact factor: 1.458