The pattern of diabetes care in New South Wales: a five-year analysis using Medicare occasions of service data.
OBJECTIVE
To use Medicare occasions of service data to establish the pattern and standard of care received by people with diabetes.


METHODS
Information about visits to medical practitioners as well as utilisation of diabetes related procedures for people living in New South Wales (NSW) for the individual years between 1993 to 1997 was retrieved using a Health Insurance Commission data file. Individuals were deemed to have diabetes if an HbA1c which can only be ordered for a person with known diabetes, had been performed over the five-year period.


RESULTS
On average over the study period, persons with diabetes accounted for 3.1% of the population but they used 5.5% of general practitioner services. A large proportion of patients also received care at the specialist and consultant physician level, 51.2% and 38.6% respectively, a three to four fold increase when compared with their non-diabetic counterparts. There was also a 1.3 to 1.8 fold increase in the mean number of attendances to the various medical practitioners. Surveillance of diabetes parameters was inadequate but small improvements were seen over the 5 year study period (proportion of persons with diabetes with a HbA1c performed: 48.8% to 56.8%; Lipids: 49.4% to 52.0%; HDL cholesterol: 18.3% to 18.8%; microalbuminuria: 4.7% to 11.6%).


CONCLUSIONS
This study has highlighted the heavy burden imposed by diabetes on our health care system.


CONCLUSIONS
The use of Medicare occasions of service data represents a cost efficient way of monitoring health service utilisation.
Overland
J
J
Diabetes Centre of Royal Prince Alfred Hospital, Sydney, University of Sydney, New South Wales. jane@diab.rpa.cs.nsw.gov.au
Yue
D K
DK
Mira
M
M
D003920:Diabetes Mellitus / Q000191:economics / Q000517:prevention & control*; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D009313:National Health Programs / Q000706:statistics & numerical data; D009517:New South Wales; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data