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    Relationship between primary care visits and hospital admissions in remote Indigenous patients with diabetes: A multivariate spline regression model

    Access Status
    Fulltext not available
    Authors
    Zhao, Y.
    Connors, C.
    Lee, Andy
    Liang, Wenbin
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Zhao, Y. and Connors, C. and Lee, A. and Liang, W. 2015. Relationship between primary care visits and hospital admissions in remote Indigenous patients with diabetes: A multivariate spline regression model. Diabetes Research and Clinical Practice. 108: pp. 106-112.
    Source Title
    Diabetes Research and Clinical Practice
    DOI
    10.1016/j.diabres.2015.01.013
    ISSN
    0168-8227
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/3755
    Collection
    • Curtin Research Publications
    Abstract

    Aims - To determine if access to primary health care (PHC) is associated with reduced hospitalisations for remote Indigenous patients with diabetes. Methods - Using individual level linked health clinic and hospital data, a retrospective cohort study was conducted to estimate annual hospital admission rate by number of clinic visits in the Northern Territory of Australia, stratified by age group, sex and the presence of comorbidities. A spline regression model was used to describe the clinic-hospital relationship with covariates. An impact index of PHC visits was derived using the first derivative of the quadratic equations evaluated at the parameter estimates. Results -The relationship between PHC visits and hospitalisations in diabetes care appeared to be a U-curve. Low levels of PHC visits were associated with increased hospital admissions amongst people with diabetes. The overall level of all-cause hospitalisations for patients with diabetes was minimised when the PHC visits were 7.9 per person-year (95% confidence interval 5.8–10). Conclusions -Using existing empirical data, this study suggests that other things being equal, diabetes patients who had an adequate level of PHC visits are likely to have a lower level of hospitalisations than those with fewer or more PHC visits. This study highlights the importance for remote Indigenous patients with diabetes to have adequate access to PHC.

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