Effects of point-of-care testing in general practice for Type 2 Diabetes patients on ambulatory visits and hospitalizations
| Autor: | Troels Kristensen, Christian Volmar Skovsgaard, Kim Rose-Olsen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
HbA1c hospital admissions Health Toxicology and Mutagenesis Point-of-care testing difference-in-differences (DID) models lcsh:Medicine 030209 endocrinology & metabolism Type 2 diabetes Ambulatory Care Facilities Article 03 medical and health sciences 0302 clinical medicine ambulatory visits Event study analysis Ambulatory care Difference-in-differences (DID) models Diabetes management Diabetes mellitus Point-of-care testing (POCT) medicine point-of-care testing (POCT) Humans 030212 general & internal medicine Referral and Consultation patient data Hospital admissions general practice diabetes business.industry lcsh:R Diabetes Public Health Environmental and Occupational Health event study analysis medicine.disease Test (assessment) Hospitalization Patient data Diabetes Mellitus Type 2 Point-of-Care Testing General practice Emergency medicine Ambulatory Ambulatory visits Family Practice business |
| Zdroj: | Kristensen, T, Rose Olsen, K & Volmar Skovsgaard, C 2020, ' Effects of point-of-care testing in general practice for Type 2 Diabetes patients on ambulatory visits and hospitalizations ', International Journal of Environmental Research and Public Health, vol. 17, no. 17, 6185, pp. 1-16 . https://doi.org/10.3390/ijerph17176185 International Journal of Environmental Research and Public Health Volume 17 Issue 17 International Journal of Environmental Research and Public Health, Vol 17, Iss 6185, p 6185 (2020) |
| Popis: | Point-of-care testing (POCT) of HbA1c means instant test results and more coherent counseling that is expected to improve diabetes management and affect ambulatory visits and hospitalizations. From late 2008, POCT has been implemented and adopted by a segment of the general practices in the capital region of Denmark. The aim of this study is to assess whether the introduction of POCT of HbA1c in general practice (GP) has affected patient outcomes for T2 diabetes patients in terms of hospital activity. We apply difference-in-differences models at the GP clinic level to assess the casual effects of POCT on the following hospital outcomes: (1) admissions for diabetes, (2) admissions for ambulatory care sensitive diabetes conditions (ACSCs), (3) ambulatory visits for diabetes. The use of POCT is remunerated by a fee, and registration of this fee is used to measure the GP&rsquo s use of POCT. The control group includes clinics from the same region that did not use POCT. The sensitivity of our results is assessed by an event study approach and a range of robustness tests. The panel data set includes 553 GP clinics and approximately 30,000 diabetes patients from the capital region of Denmark, observed in the years 2004&ndash 2012. We find that voluntary adoption of POCT of HbA1c in GP has no effect on hospital admissions and diabetes-related hospital ambulatory visits. Event study analysis and different treatment definitions confirm the robustness of these results. If implementation of POCT of HbA1c improves other parts of diabetes management as indicated in the literature, it seems worthwhile to implement POCT of HbA1c in the capital region of Denmark. However, doubts around the quality of POCT of HbA1c testing and a desire to capture data at central labs may prevent implementation of more value based HbA1c testing. |
| Databáze: | OpenAIRE |
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