title: Do diabetes clinic attendees stay out of hospital? A matched case-control study.
abstract: OBJECTIVE
  To examine whether routine care for diabetes mellitus influences the risk of hospital admission.
  
  
  METHODS
  All people with diabetes in five randomly selected general practices in the city of Leicester were identified from medical records and prescribing information. Cases with a hospital admission between 1992 and 1995 but no admission in the preceding 2 years were compared with age-matched controls in a nested study.
  
  
  RESULTS
  The variables significantly associated with an increased risk of admission were duration of diabetes in years (OR 1.07, 95% confidence interval (CI) 1.03-1.11) and number of non-diabetic drugs prescribed (OR 1.51, 95% CI 1.27-1.79). Having attended a hospital clinic in the previous 2 years was associated with reduced risk of admission (OR 0.30, 95% CI 0.14-0.65), whilst having been seen for a diabetes review in general practice was not (OR 0.91, 95% CI 0.41-1.99). Similar results were found for both diabetes-related and unrelated admissions.
  
  
  CONCLUSIONS
  Although general practice-based review was not associated with a change in the risk of admission, attendance at a hospital clinic was associated with a decreased risk of admission. These results may be explained by the characteristics of those who attend hospital clinics, as well as by the possible effectiveness of access to specialist services in reducing admissions.
authors.affiliation: Department of Epidemiology and Public Health, University of Leicester, UK. e.goyder@sheffield.ac.uk
authors.forename: E C
authors.initials: EC
authors.lastname: Goyder
authors.forename: N
authors.initials: N
authors.lastname: Spiers
authors.forename: P G
authors.initials: PG
authors.lastname: McNally
authors.forename: M
authors.initials: M
authors.lastname: Drucquer
authors.forename: J L
authors.initials: JL
authors.lastname: Botha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000628:therapy*; D004739:England; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012307:Risk Factors