Building the evidence for integrated care for type 2 diabetes: a pilot study.
Integrated care models have the potential to reduce fragmentation in the health system and improve outcomes for people with type 2 diabetes. A pilot evaluation of an integrated care model for people with type 2 diabetes in Melbourne, Australia, is reported on. Two studies were conducted: (1) a 6-month pilot randomised controlled trial (n=56) evaluating the impact of the integrated care model relative to hospital outpatient clinics; and (2) a cross-sectional study (n=92) of patients attending the two services. The primary outcome was diabetes-specific distress; secondary outcomes were perceived quality of diabetes care, diabetes-specific self-efficacy and glycated haemoglobin (HbA1c). There was no effect of service setting on diabetes-specific distress. Participants from the integrated care setting perceived the quality of diabetes care to be higher than did participants from the hospital clinics. Significant HbA1c improvements were observed over time, but with no effect of service setting. The model holds promise for people with type 2 diabetes who need more specialist/multidisciplinary care than can be provided in primary care. Patients' evaluations of the quality of diabetes care received at the integrated care service are very positive, which is likely to be one of the key strengths of the integrated model.
The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia - Victoria, 570 Elizabeth Street, Melbourne, Vic. 3000, Australia.
Jessica L
JL
Browne
The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia - Victoria, 570 Elizabeth Street, Melbourne, Vic. 3000, Australia.
Jane
J
Speight
Carrington Health, 3/43 Carrington Road, Box Hill, Vic. 3128, Australia.
Carina
C
Martin
Eastern Health Clinical School, Monash University, Level 2, 5 Arnold Street, Box Hill, Vic. 3128, Australia.
Christopher
C
Gilfillan
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D019468:Disease Management; D005260:Female; D058006:General Practice; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D011787:Quality of Health Care; D020377:Self Efficacy; D016896:Treatment Outcome; D014739:Victoria
D006442:Glycated Hemoglobin