title: The impact of patient and practice characteristics on retention in the diabetes annual review programme.
abstract: BACKGROUND
  Despite more than 10 years of the diabetes annual review (DAR) programme, ensuring the annual return of diabetic patients for review remains a challenge for primary care. Regardless of future arrangements for diabetes review programmes, regular review of patients remains clinically important.
  
  
  OBJECTIVE
  To investigate the effect of patient and practice characteristics on the retention of patients continuously enrolled with the same practice in the DAR programme.
  
  
  METHODS
  We undertook a retrospective, observational study of a cohort of enrolled diabetic patients who had a DAR in the July 2006 - June 2007 reporting year and remained enrolled with the same practice for the following three years. Controlling for death and migration, retention rates were calculated for age, gender, ethnicity, rurality, practice funding type and practice nurse (PN) to general practitioner (GP) ratio.
  
  
  RESULTS
  The study included data from 78 practices and 6610 patients with Type 2 diabetes. Non-Maori and those aged 60 years and over were more likely to be retained in the programme. For practice factors, those with a higher PN to GP ratio had a significant retention advantage. Rurality and funding type was not shown to have a significant role in retention.
  
  
  CONCLUSIONS
  Results support the view that both patient and practice factors influence a patient's retention within the DAR programme. The PN to GP ratio may be an important factor in the retention of patients in a DAR programme and warrants further research and consideration when planning future primary care models.
authors.affiliation: Midlands Health Network, PO Box 983, Hamilton 3240, New Zealand. rawiri.keenan@midlandshn.health.nz
authors.forename: Rawiri
authors.initials: R
authors.lastname: Keenan
authors.forename: Janet
authors.initials: J
authors.lastname: Amey
authors.forename: Ross
authors.initials: R
authors.lastname: Lawrenson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D009722:Nurse Practitioners / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000458:organization & administration; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors