Impact of primary care on hospital admission rates for diabetes patients: A systematic review
| Autor: | Michel Wensing, René Wolters, Jozé Braspenning |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Ethnic group Patient characteristics Primary care Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] 03 medical and health sciences Hba1c level Strength of evidence 0302 clinical medicine Endocrinology Ambulatory care Diabetes mellitus Internal Medicine medicine Diabetes Mellitus Humans 030212 general & internal medicine Quality of Health Care Primary Health Care business.industry 030503 health policy & services General Medicine medicine.disease Hospitalization Hospital admission Emergency medicine 0305 other medical science business |
| Zdroj: | Diabetes Research and Clinical Practice, 129, pp. 182-196 Diabetes Research and Clinical Practice, 129, 182-196 |
| ISSN: | 0168-8227 |
| Popis: | Item does not contain fulltext High-quality primary care for diabetes patients may be related to lowered hospital admissions. A systematic search was performed to assess the impact of structure, process, and outcome of primary diabetes care on hospital admission rates, considering patient characteristics. Studies on diabetes patients in primary care with hospitalisation rates as outcomes published between January 1996 and December 2015 were included. Indicators of quality of care (access, continuity and structure of care, process, and outcome indicators) and patient characteristics (age, gender, ethnicity, insurance, socio-economic status, diabetes characteristics, co-morbidity, and health-related lifestyle) were extracted. After assessment of the strength of evidence, characteristics of care and diabetes patients were presented in relation to the likelihood of hospitalisation. Thirty-one studies were identified. A regular source of primary care and a well-controlled HbA1c level decreased the likelihood of hospitalisation. Other aspects of care were less consistent. Patients' age, co-morbidity, and socio-economic status were related to higher hospitalisation. Gender and health-related lifestyle showed no relationship. Studies were heterogeneous in design, sample, and healthcare system. Different definitions of diabetes and unscheduled admissions limited comparisons. In healthcare systems where diabetes patients have a regular source of primary care, hospital admission rates cannot be meaningfully related to primary care characteristics. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect