title: Resources and population served: a description of the Ontario Paediatric Diabetes Network.
abstract: BACKGROUND
  The Network of Ontario Pediatric Diabetes Programs was established in 2001 to provide access to specialized pediatric diabetes care. Universal funding for pediatric insulin pump therapy has been available in Ontario since 2006. The objective of this study was to describe the distribution of patients, resources and insulin pump use across centres within the network, now called the Ontario Paediatric Diabetes Network.
  
  
  METHODS
  We conducted a cross-sectional survey in 2012 of the 35 pediatric diabetes centres in Ontario to measure centre characteristics, patient volume and available clinical and social resources. We used health administrative data from the provincial Assistive Devices Program to describe patients aged 18 years or less using insulin pumps by centre as a measure of technology uptake.
  
  
  RESULTS
  All 35 centres participated, reporting a total of 6676 children with type 1 diabetes and 368 with type 2 diabetes. Most (> 80%) children with type 1 diabetes were followed at tertiary (n = 5) or large community (n = 14) centres. Nursing patient load was similar between centre types, but there was a large range across centres within any type. Overall, percent insulin pump use was 38.1% and varied widely across centres (5.3%-66.7%). Funded 24-hour support for pump users was available at 5 (36%) small community centres, 3 (19%) large community centres and 2 (40%) tertiary centres.
  
  
  CONCLUSIONS
  Our study showed differences in access to specialized and after-hours care for children with diabetes in Ontario. Pump use varied widely across centres. Further research is needed to assess the impact of these observed differences on quality of care and outcomes.
authors.affiliation: Department of Pediatrics (Shulman, Daneman, Guttmann), The Hospital for Sick Children, University of Toronto; Institute of Health Policy, Management and Evaluation (Shulman, Miller, Stukel, Guttmann), University of Toronto; Institute for Clinical Evaluative Sciences (Shulman, Stukel, Guttmann); Toronto Health Economics and Technology Assessment (THETA) Collaborative (Miller), University of Toronto, Toronto, Ont.
authors.forename: Rayzel
authors.initials: R
authors.lastname: Shulman
authors.affiliation: Department of Pediatrics (Shulman, Daneman, Guttmann), The Hospital for Sick Children, University of Toronto; Institute of Health Policy, Management and Evaluation (Shulman, Miller, Stukel, Guttmann), University of Toronto; Institute for Clinical Evaluative Sciences (Shulman, Stukel, Guttmann); Toronto Health Economics and Technology Assessment (THETA) Collaborative (Miller), University of Toronto, Toronto, Ont.
authors.forename: Fiona A
authors.initials: FA
authors.lastname: Miller
authors.affiliation: Department of Pediatrics (Shulman, Daneman, Guttmann), The Hospital for Sick Children, University of Toronto; Institute of Health Policy, Management and Evaluation (Shulman, Miller, Stukel, Guttmann), University of Toronto; Institute for Clinical Evaluative Sciences (Shulman, Stukel, Guttmann); Toronto Health Economics and Technology Assessment (THETA) Collaborative (Miller), University of Toronto, Toronto, Ont.
authors.forename: Therese A
authors.initials: TA
authors.lastname: Stukel
authors.affiliation: Department of Pediatrics (Shulman, Daneman, Guttmann), The Hospital for Sick Children, University of Toronto; Institute of Health Policy, Management and Evaluation (Shulman, Miller, Stukel, Guttmann), University of Toronto; Institute for Clinical Evaluative Sciences (Shulman, Stukel, Guttmann); Toronto Health Economics and Technology Assessment (THETA) Collaborative (Miller), University of Toronto, Toronto, Ont.
authors.forename: Denis
authors.initials: D
authors.lastname: Daneman
authors.affiliation: Department of Pediatrics (Shulman, Daneman, Guttmann), The Hospital for Sick Children, University of Toronto; Institute of Health Policy, Management and Evaluation (Shulman, Miller, Stukel, Guttmann), University of Toronto; Institute for Clinical Evaluative Sciences (Shulman, Stukel, Guttmann); Toronto Health Economics and Technology Assessment (THETA) Collaborative (Miller), University of Toronto, Toronto, Ont.
authors.forename: Astrid
authors.initials: A
authors.lastname: Guttmann