title: Are general practice characteristics predictors of good glycaemic control in patients with diabetes? A cross-sectional study.
abstract: OBJECTIVE
  To determine whether certain characteristics of general practices are associated with good glycaemic control in patients with diabetes and with completing an annual cycle of care (ACC).
  
  
  METHODS
  Our cross-sectional analysis used baseline data from the Australian Diabetes Care Project conducted between 2011 and 2014. Practice characteristics were self-reported. Characteristics of the patients that were assessed included glycaemic control (HbA1c level ≤ 53 mmol/mol), age, sex, duration of diabetes, socio-economic disadvantage (SEIFA) score, the complexity of the patient's condition, and whether the patient had completed an ACC for diabetes in the past 18 months. Clustered logistic regression was used to establish predictors of glycaemic control and a completed ACC.
  
  
  RESULTS
  Data were available from 147 general practices and 5455 patients with established type 1 or type 2 diabetes in three Australian states. After adjustment for other patient characteristics, only the patient completing an ACC was statistically significant as a predictor of glycaemic control (P = 0.011). In a multivariate model, the practice having a chronic disease-focused practice nurse (P = 0.036) and running educational events for patients with diabetes (P = 0.004) were statistically significant predictors of the patient having complete an ACC.
  
  
  CONCLUSIONS
  Patient characteristics are moderately good predictors of whether the patient is in glycaemic control, whereas practice characteristics appear to predict only the likelihood of patients completing an ACC. The ACC is an established indicator of good diabetes management. This is the first study to report a positive association between having completed an ACC and the patient being in glycaemic control.
authors.affiliation: University of South Australia, Adelaide, SA Adrian.Esterman@unisa.edu.au.
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Esterman
authors.affiliation: McKinsey & Co, Sydney, NSW.
authors.forename: Tim
authors.initials: T
authors.lastname: Fountaine
authors.affiliation: Centre for Research Excellence in Chronic Disease Prevention, James Cook University, Cairns, QLD.
authors.forename: Robyn
authors.initials: R
authors.lastname: McDermott
mesh_terms: D000368:Aged; D001315:Australia; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D005260:Female; D058006:General Practice / Q000592:standards*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D016015:Logistic Models; D008297:Male
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human