Do children with cystic fibrosis receiving outreach care have poorer clinical outcomes than those treated at a specialist cystic fibrosis centre?
| Autor: | Rodney Ehrlich, Sean Beggs, Ingrid Els, Philip F. Robinson, Nicole Saxby, Heinrich C. Weber |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty paediatric Cystic Fibrosis Victoria Child Health Services Cystic fibrosis Health Services Accessibility Tasmania Retrospective database cystic fibrosis centre 03 medical and health sciences 0302 clinical medicine Outcome Assessment Health Care SEIFA medicine Humans Pseudomonas Infections 030212 general & internal medicine outreach care Healthcare Disparities Child comparative study Disadvantage Original Research Shared care business.industry Public Health Environmental and Occupational Health medicine.disease Outreach Treatment Outcome 030228 respiratory system Family medicine Female Rural Health Services Family Practice Urban centre business Body mass index |
| Zdroj: | The Australian Journal of Rural Health |
| ISSN: | 1038-5282 |
| Popis: | Introduction Although cystic fibrosis (CF) centre care is generally considered ideal, children living in regional Australia receive outreach care supported by the academic CF centres. Methods This is a retrospective database review of children with CF treated at the Royal Children's Hospital in Melbourne and its outreach clinics in Albury (Victoria), and Tasmania. The aim was to compare the outcomes of children with CF managed at an academic centre with that of outreach care, using lung function, nutritional status and Pseudomonas aeruginosa colonisation. Three models of care, namely CF centre care, Shared care and predominantly Local care, were compared, based on the level of involvement of CF centre multidisciplinary team. In our analyses, we controlled for potential confounders, such as socio-economic status and the degree of remoteness, to determine its effect on the outcome measures. Results There was no difference in lung function, i.e. forced expiratory volume in 1 s (FEV1), the prevalence of Pseudomonas aeruginosa colonisation or nutritional status (body mass index (BMI)) between those receiving CF centre care and various modes of outreach care. Neither socio-economic status, measured by the Socio-Economic Index for Area (SEIFA) for disadvantage, nor distance from an urban centre (Australian Standard for Geographical Classification (ASGC)) were associated with lung function and nutritional outcome measures. There was however an association between increased Pseudomonas aeruginosa colonisation and poorer socio-economic status. Conclusion Outcomes in children with CF in regional and remote areas receiving outreach care supported by an academic CF centre were no different from children receiving CF centre care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text