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Geography does not limit optimal diabetes care: use of a tertiary centre model of care in an outreach service for type 1 diabetes mellitus.
- Source :
-
Journal of paediatrics and child health [J Paediatr Child Health] 2014 Jun; Vol. 50 (6), pp. 471-5. Date of Electronic Publication: 2014 Feb 19. - Publication Year :
- 2014
-
Abstract
- Aim: Young people with type 1 diabetes mellitus living in rural and regional Australia have previously been shown to have limited access to specialised diabetes services. The Royal Children's Hospital Melbourne has been running diabetes outreach clinics to Western Victoria, Australia, for over 13 years. We aim to evaluate this service by comparing the outcomes of three outreach clinics with our urban diabetes clinic at the Royal Children's Hospital Melbourne.<br />Methods: We examine our tertiary, multidisciplinary team-based model of care, where visiting specialist medical staff work alongside local allied health teams. The local teams provide interim care between clinics utilising the same protocols and treatment practices as the tertiary centre. Longitudinal data encapsulating the years 2005-2010, as a cohort study with a control group, are reviewed.<br />Results: A total of 69 rural patients were compared with 1387 metropolitan patients. Metabolic control was comparable, with no difference in mean HbA1c (8.3%/67 mmol/mol for both groups). Treatment options varied slightly at diagnosis, while insulin pump usage was comparable between treatment settings (20.3% rural compared with 27.6% urban, P = 0.19). Of note was that the number of visits per year was higher in the rural group (3.3 per year rural compared with 2.7 urban, P < 0.001).<br />Conclusions: We conclude that the outreach service is able to provide a comparable level of care when the urban model is translated to a rural setting. This model may be further able to be extrapolated to other geographic areas and also other chronic health conditions of childhood.<br /> (© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)
- Subjects :
- Adolescent
Ambulatory Care statistics & numerical data
Child
Community-Institutional Relations
Diabetes Mellitus, Type 1 diagnosis
Disease Management
Female
Hospitals, Pediatric
Humans
Insulin therapeutic use
Interinstitutional Relations
Longitudinal Studies
Male
Risk Assessment
Rural Population
Tertiary Care Centers
Treatment Outcome
Urban Population
Victoria
Diabetes Mellitus, Type 1 drug therapy
Geography
Health Services Accessibility statistics & numerical data
Monitoring, Physiologic methods
National Health Programs organization & administration
Quality of Health Care
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1754
- Volume :
- 50
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of paediatrics and child health
- Publication Type :
- Academic Journal
- Accession number :
- 24548056
- Full Text :
- https://doi.org/10.1111/jpc.12499