title: Relative activity and referral patterns for diabetes and non-diabetes in general practice.
abstract: OBJECTIVE
  To describe and compare general practice (GP) activity for patients with and without diabetes using a survey of general practices representing over 10% of the Welsh population.
  
  
  METHODS
  The Welsh GP Morbidity Database Project (GPMDP) collected data including demographic and lifestyle information and consultation data such as diagnosis, referral and surgical procedures. These data were analysed to establish the annual period prevalence of diabetes and compare the relative number of consultations and referrals.
  
  
  RESULTS
  A total of 4,182 diabetic patients were recorded (prevalence 1.41%) and accounted for 77,371 (4.4%) consultations. Patients with diabetes were four-times more likely to be referred to community services (relative risk (RR) 4.1, 95% CI 3.7-4.7), in particular district nursing (RR 3.8, 1.9-7.7), optician services (RR 8.9, 5.0-15.7), chiropody (RR 8.2 6.4-10.5) and dietician services (RR 21.2, 17.6-25.5). Patients with diabetes were also more likely to be followed-up in general practice (RR 6.7, 6.2-7.2) both within 1 month (RR 6.7, 6.2-7.2) and 1 month to 1 year (RR 9.7, 8.9-10.7). Emergency admissions were also more likely for patients with diabetes (RR 6.8, 6.2-7.5) as were elective admissions to general medicine (RR 5.6, 4.6-6.7), surgery (RR 1.8, 1.5-2.0) and opthalmology (4.2, 3.4-5.2).
  
  
  CONCLUSIONS
  The increased utilization of health services apparent in secondary care was confirmed in primary care. Further research is required to determine levels of community activity after initial referral.
authors.affiliation: Department of Medicine, University Hospital of Wales, Cardiff, UK. MorganCL@cf.ac.uk
authors.forename: C L
authors.initials: CL
authors.lastname: Morgan
authors.forename: C J
authors.initials: CJ
authors.lastname: Currie
authors.forename: J
authors.initials: J
authors.lastname: Hunt
authors.forename: J D
authors.initials: JD
authors.lastname: Evans
authors.forename: C
authors.initials: C
authors.lastname: Rogers
authors.forename: N C
authors.initials: NC
authors.lastname: Stott
authors.forename: J R
authors.initials: JR
authors.lastname: Peters
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003153:Community Health Services; D016208:Databases, Factual; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D004739:England; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D014852:Wales