Relationship between primary care visits and hospital admissions in remote Indigenous patients with diabetes: A multivariate spline regression model
| Autor: | Yuejen Zhao, Christine Connors, Andy H. Lee, Wenbin Liang |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Multivariate statistics Native Hawaiian or Other Pacific Islander Adolescent Endocrinology Diabetes and Metabolism education Primary health care Primary care behavioral disciplines and activities Indigenous Young Adult Patient Admission Endocrinology Population Groups Diabetes mellitus Health care Diabetes Mellitus Prevalence Internal Medicine Humans Medicine Child Retrospective Studies Primary Health Care business.industry Australia Infant Newborn Infant Retrospective cohort study General Medicine Middle Aged medicine.disease Confidence interval Child Preschool Family medicine Regression Analysis Female business Follow-Up Studies |
| Zdroj: | Diabetes Research and Clinical Practice. 108:106-112 |
| ISSN: | 0168-8227 |
| Popis: | Aims To determine if access to primary health care (PHC) is associated with reduced hospitalisations for remote Indigenous patients with diabetes. Methods Using individual level linked health clinic and hospital data, a retrospective cohort study was conducted to estimate annual hospital admission rate by number of clinic visits in the Northern Territory of Australia, stratified by age group, sex and the presence of comorbidities. A spline regression model was used to describe the clinic-hospital relationship with covariates. An impact index of PHC visits was derived using the first derivative of the quadratic equations evaluated at the parameter estimates. Results The relationship between PHC visits and hospitalisations in diabetes care appeared to be a U-curve. Low levels of PHC visits were associated with increased hospital admissions amongst people with diabetes. The overall level of all-cause hospitalisations for patients with diabetes was minimised when the PHC visits were 7.9 per person-year (95% confidence interval 5.8–10). Conclusions Using existing empirical data, this study suggests that other things being equal, diabetes patients who had an adequate level of PHC visits are likely to have a lower level of hospitalisations than those with fewer or more PHC visits. This study highlights the importance for remote Indigenous patients with diabetes to have adequate access to PHC. |
| Databáze: | OpenAIRE |
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