title: Continuity of care in diabetes: to whom does it matter?
abstract: The Australian health care system allows patients to move around to seek medical treatment. This may impact negatively on continuity of care. To determine factors associated with continuity of care for persons with diabetes, the profiles of 479 patients attending the Diabetes Centre, Royal Prince Alfred Hospital, Sydney, Australia, were examined. The majority of patients (87.7%) attended only one general practitioner and had been under the care of the referring doctor for a median of 6.2 years. These patients were older (P=0.02), but were comparable with those attending multiple doctors in terms of their type, duration and treatment of diabetes as well as their clinical and complication profile. There was also a relationship between age and the length of time under the care of the referring doctor (P=0.0002). The HbA(1c), lipid, blood pressure and treatment profiles of patients attending the referring doctor short, medium or long-term were comparable. However, there was an upward trend in the proportion of patients with a history of cerebrovascular disease, ischaemic heart disease or any complication of diabetes with each incremental increase in length of time under the referring doctor. Appropriately, patients seek continuity of care as they age and their health needs become more complex.
authors.affiliation: Diabetes Centre of Royal Prince Alfred Hospital, 10th Floor, Queen Mary Building, Grose St, Camperdown NSW 2050, Australia. jane@diab.rpa.cs.nsw.gov.au
authors.forename: J
authors.initials: J
authors.lastname: Overland
authors.forename: D K
authors.initials: DK
authors.lastname: Yue
authors.forename: M
authors.initials: M
authors.lastname: Mira
mesh_terms: D000368:Aged; D000419:Albuminuria; D001315:Australia; D001794:Blood Pressure; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D003266:Continuity of Patient Care; D003695:Delivery of Health Care; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005194:Family Practice; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D012017:Referral and Consultation
chemical_list: D006442:Glycated Hemoglobin